Home About us Editorial board Current issue Search Archives Submit article Instructions Subscribe Contact Us Login 
An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists


 
  Table of Contents    
ENIGMATIC MORPHO INSIGHT  
Year : 2018  |  Volume : 22  |  Issue : 1  |  Page : 9-10
 

Sanderson's polster


1 Department of Clinical Laboratory Services and Translational Research, Malabar Cancer Center, Kannur, Kerala, India
2 Department of Oral and Maxillofacial Pathology, V S Dental College, Bengaluru, Karnataka, India

Date of Web Publication13-Apr-2018

Correspondence Address:
T Smitha
Department of Oral and Maxillofacial Pathology, V S Dental College, Bengaluru, Karnataka
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jomfp.JOMFP_45_18

Rights and Permissions

 



How to cite this article:
Pandiar D, Smitha T. Sanderson's polster. J Oral Maxillofac Pathol 2018;22:9-10

How to cite this URL:
Pandiar D, Smitha T. Sanderson's polster. J Oral Maxillofac Pathol [serial online] 2018 [cited 2018 Aug 22];22:9-10. Available from: http://www.jomfp.in/text.asp?2018/22/1/9/230045


The usage of the term “Sanderson's Polster” is cited in literature mainly in the first half of the 20th century. Sanderson-Damberg (1911) used the term Sanderson's polster, and probably Aschoff (1925) called similar structures as “Proliferationsknospe.”[1],[2] “ Polster” is a German word that means a “cushion,” “pillow” and “bolster,” hence a metonymic occupational name for a maker or seller of pillows or a nickname for a plump man, and thus this word was probably used to denote based on the appearance of small secondary follicles within an enlarged follicle resembling a “cushion” or “pillow” attached to one end.

In normal thyroid gland or more commonly in hyperplastic conditions of thyroid gland such as nodular/multinodular goiter, adenomatoid goiter, or adenomatous hyperplasia, microscopically dilated thyroid follicles lined by cuboidal cells and filled with colloid may be seen. When colloid secretion increases in the small secondary follicles, their mass bulges into the follicular cavity and gives rise to a “Sanderson Polster” seen at one pole along the follicular wall of enlarged and dilated follicles.[3] These dilated follicles are usually 2–3 times larger than the surrounding follicles [Figure 1]. [Figure 2] shows hand-drawn pictures corresponding to [Figure 1]. Sanderson's polster is composed mainly of small follicles lined by cuboidal cells [Figure 3]. Goormaghtigh and Thomas suggested the term “papilla” for these structures.[3] These secondary acini are nearly always lined with large epithelial cells, and the nuclei are conspicuous by their size. In an early study, Sugiyama et al. could not find “Sanderson's Polster” or “Proliferationsknospe” in the normal development of thyroid gland.[4]
Figure 1: Photomicrograph of H&E section showing Sanderson polsters within an enlarged follicle (×40)

Click here to view
Figure 2: Corresponding hand-drawn illustration of Figure 1: (1) The enlarged follicle, (2) secondary follicles (Sanderson polsters), and (3) colloid

Click here to view
Figure 3: Photomicrograph of H&E section showing Sanderson polsters (×400)

Click here to view


Based on histochemical staining in aged murine thyroid tissue, Lee et al. opined that Sanderson's polsters, small follicles and irregularly-shaped follicles, were hyperactive as compared with markedly enlarged follicles.[5] Abundant colloid in large follicles was stained purple-red or dark blue-purple by PAS, while cellular areas composed of small follicles were pale-red or negative. In another study, Aeschimann et al. considered similar budding intraluminal protrusions as actively replicating, while flat neighboring patches were apparently resting. The results were drawn on the basis of p21 ras immunohistochemistry. p21 ras can be used as a growth marker. The areas of active growth show a significant increase in cellular p2l ras as compared to resting cells which contain very little p21 ras.[6]

Instead of microfollicles at one pole, it is not unusual to find benign papillary formations protruding into the lumen of large follicles [Figure 4]. Such papillary protrusions should not be confused with papillary carcinoma of thyroid (PTC), as they lack the classical PTC nuclear features such as clearing of chromatin, nuclear enlargement, intranuclear cytoplasmic pseudoinclusions, nuclear grooving and nuclear overlapping.
Figure 4: Photomicrograph showing multiple papillary fronds at one pole of large colloid filled thyroid follicle in a case of nodular colloid goiter

Click here to view


Despite the fact that these structures are sometimes described as areas of active growth, clinically majority remains entirely benign. However, familiarization with such terms may avoid an overdiagnosis of thyroid malignancy.

Acknowledgment:

Dr Sangeetha K Nayanar, Professor and HOD, Department of Clinical Laboratory Services and Translational Research, Malabar Cancer Center, Thalassery, Kerala.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Sanderson-Damberg E. The thyroid glands from 15.-25. Year of life from the North German plain and coastal area as well as from Bern. Frankfurt Z Path 1911;6:312-34.  Back to cited text no. 1
    
2.
Aschoff L. Lectures on Pathology Held at the Universities and Academies of Japan in 1924. Jena: Gustav Fischer; 1925. p. 1-309.  Back to cited text no. 2
    
3.
Goormaghtigh N, Thomas F. The functional reactions of the human thyroid: A Contribution to its histophysiology. Am J Pathol 1934;10:713-30.  Back to cited text no. 3
[PUBMED]    
4.
Sugiyama S, Taki A, Nakano A, Sugiyama N, Yamamoto Y. Histological studies of the human thyroid gland in middle and late prenatal life. Okajimas Folia Anat Jpn 1959;33:75-84.  Back to cited text no. 4
    
5.
Lee J, Yi S, Kang YE, Kim HW, Joung KH, Sul HJ, et al. Morphological and functional changes in the thyroid follicles of the aged murine and humans. J Pathol Transl Med 2016;50:426-35.  Back to cited text no. 5
[PUBMED]    
6.
Aeschimann S, Kopp PA, Kimura ET, Zbaeren J, Tobler A, Fey MF, et al. Morphological and functional polymorphism within clonal thyroid nodules. J Clin Endocrinol Metab 1993;77:846-51.  Back to cited text no. 6
[PUBMED]    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

Top
Print this article  Email this article
            

    

 
   Search
 
  
    Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
    Article in PDF (2,153 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  


    References
    Article Figures

 Article Access Statistics
    Viewed424    
    Printed8    
    Emailed0    
    PDF Downloaded124    
    Comments [Add]    

Recommend this journal

Journal of Oral and Maxillofacial Pathology | Published by Wolters Kluwer - Medknow
Online since 15th Aug, 2007