Carcinoma showing thymus‐like elements (CASTLE) with amyloid deposition in the parotid gland

Carcinoma showing thymus‐like elements (CASTLE) is a rare tumor that commonly occurs in the thyroid gland. Extrathyroidal CASTLE is rarer, and only 11 cases of CASTLE of major salivary glands have been reported to date. We report the first case of amyloid deposition in parotid CASTLE. A 63‐year‐old...

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Bibliographic Details
Published in:Pathology international 2024-04, Vol.74 (4), p.227-233
Main Authors: Hamada, Mei, Miyama, Yu, Matsumura, Satoko, Shintani‐Domoto, Yukako, Urano, Makoto, Yasuda, Masanori
Format: Article
Language:English
Subjects:
amyloid
Biopsy
Cancer
carcinoma showing thymus‐like elements
Carcinoma, Squamous Cell - pathology
Case Report
CASTLE
Castles
CD5 antigen
Computed tomography
Cytokeratin
Deposition
Exocrine glands
Glands
Humans
Immunoreactivity
Lesions
Lymph
Lymph nodes
Male
Metastases
Middle Aged
Neoplasms
Neoplasms, Glandular and Epithelial
Nests
Parotid gland
Parotid Gland - pathology
PD‐L1
Salivary gland
Salivary glands
Squamous cell carcinoma
Thymus
Thymus gland
Thymus Gland - pathology
Thymus Neoplasms
Thyroid
Thyroid gland
Thyroid Neoplasms - pathology
Tomography
Tumor cells
Tumors
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Summary:Carcinoma showing thymus‐like elements (CASTLE) is a rare tumor that commonly occurs in the thyroid gland. Extrathyroidal CASTLE is rarer, and only 11 cases of CASTLE of major salivary glands have been reported to date. We report the first case of amyloid deposition in parotid CASTLE. A 63‐year‐old man presented with a slowly growing mass in the left parotid region. Computed tomography revealed an approximately 28 × 23 mm mass lesion in the left parotid gland, and squamous cell carcinoma was suspected on biopsy. The patient underwent a parotidectomy with neck dissection. Morphologically, the tumor cells were squamoid and formed nests with lymphoid infiltration. Immunohistochemically, the tumor cells exhibited immunoreactivity for CD5, CD117/c‐kit and Bcl‐2, p40, and CK5 but not for p16. We diagnosed the tumor as parotid CASTLE. Amyloid deposition was also observed in the primary tumor and metastatic lymph node lesions, which were immunoreactive for cytokeratin 5. Tumor cytokeratin‐derived amyloid deposition may be one of characteristics of parotid CASTLE.
ISSN:1320-5463
1440-1827
1440-1827
DOI:10.1111/pin.13420