Thyroid & parathyroid
Benign thyroid neoplasms
Paraganglioma
Author: Sheren Younes, M.D.
Topic Completed: 1 September 2014
Minor changes: 31 December 2020
Copyright: 2014-2021, PathologyOutlines.com, Inc.
PubMed Search: paraganglioma thyroid
Table of Contents
Definition / general | Clinical features | Case reports | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Positive stains | Negative stains | Differential diagnosisCite this page: Younes S. Paraganglioma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/thyroidparaganglioma.html. Accessed October 25th, 2021.
Definition / general
- Uncommon neuroendocrine tumor arising from neural crest cells in paraganglia of autonomic nervous system
- Usually ages 40 - 60 years, female
- Usually benign behavior
Clinical features
- Solitary thyroid nodule of long duration
- May manifest with hypertension
- Can occur in setting of hereditary paraganglioma syndrome
Case reports
- 24 year old man (Thyroid 2007;17:575)
- 36 year old woman with primary sclerosing paraganglioma (Ann Otol Rhinol Laryngol 2012;121:510)
- 46 year old women (J Endocrinol Invest 2004;27:788, Acta Cytol 2002;46:1133)
- 63 year old woman (Acta Otorhinolaryngol Ital 2009;29:97)
- Excision of thyroid paraganglioma (Eur J Surg 2001;167:392)
Gross description
- Usually circumscribed but sometimes infiltrative
Microscopic (histologic) description
- Cells are arranged in organoid (zelbellen) arrangement
- Chief cells are surrounded by richly vascular septa with sustentacular cells
- Chief cells are round-oval, with eosinophilic, granular or vacuolated cytoplasm, uniform nuclei, dispersed chromatin; nuclei may be enlarged hyperchromatic or bizarre (variable atypia)
- Sustentacular cells are spindled and basophilic
Microscopic (histologic) images
AFIP images
Distinct nesting pattern
Sustentacular cells are S100+
Images hosted on other servers:
Variably sized nests
Moderately pleomorphic
S100, dendritic pattern
Cytology description
- Low to moderate cellularity
- Bloody background
- Cells are polygonal, have moderate to abundant cytoplasm with fine reddish intracytoplasmic granules, slight basophilia, ill defined margins, round-oval nuclei, mild-moderate pleomorphism
Positive stains
- Chromogranin, synaptophysin, NSE (chief cells)
- S100 (sustentacular cells)
Negative stains
Differential diagnosis
- Hürthle cell neoplasm
- Hyalinizing trabecular adenoma
- Metastatic carcinoid tumor
- Paraganglioma-like medullary carcinoma (Thyroid 2005;15:1363)
