Earlier, they have been regarded as variants of papillary thyroid carcinoma (PTC), hyperplastic lesions, and follicular neoplasms. We report the cytological and histological findings of a patient with an oncocytic variant of papillary thyroid carcinoma (PTC) with concurrent Hashimoto's thyroiditis. PTC is associated with radiation exposure. Protocol posting date: June 2017 . Encapsulated papillary oncocytic neoplasms (EPONs) of the thyroid are rare tumors, whose relationship to other thyroid tumors has not been thoroughly elucidated. Non-invasive follicular thyroid neoplasm with papillarylike nuclear features (NIFTP) is a new name for a very low risk thyroid tumor previously known as an Encapsulated Non-invasive Follicular Variant Papillary Thyroid Carcinoma. Rare type of papillary carcinoma (PTC) characterized by nuclear features of papillary carcinoma and oncocytic / oxyphilic / Hürthle cell like cytoplasm (mitochondria-rich) The oncocytic variant of papillary thyroid carcinoma (oncocytic variant of PTC) is a very rare subtype of PTC. Cytopathology of Follicular Cell Nodules. However, we cannot answer medical or research questions or give advice. Oncocytic variant PTC was present in 5% of PTC patients. This site needs JavaScript to work properly. Although this variant has been known for about 35 years, it has not been sufficiently reported in the literature. In the cytological diagnosis, this variant could be confused with other oncocytic lesions of the thyroid. 8600 Rockville Pike Psammoma bodies. Coexisting Hashimoto's thyroiditis with differentiated thyroid cancer and benign thyroid diseases: indications for thyroidectomy. Would you like email updates of new search results? prognosis, and treatment of the follicular variant of papillary thyroid carcinoma (FVPTC). Notes: 1. 4. Oncocytic variant PTC was present in 5% of PTC patients. Papillary thyroid carcinoma (PTC) has many subtypes. four major types; papillary thyroid carcinoma, follicular thyroid carcinoma, anaplastic thyroid carcinoma, and medullary thyroid carcinoma. Accessibility These cells have the nuclear features that characterize the papillary carcinomas of the thyroid gland. Post-Sx iodine scan. Medical school memory device P's: 1. 3. 2009 Dec;29(6):305-11. Several studies have demonstrated a poorer prognosis for specific subtypes of papillary thyroid cancers, including tall cell, insular, and hobnail variants. 3. Patients with rare variants of papillary carcinoma thyroid need to be managed more aggressively than are those with classical papillary cancer of the same stage. Its clinical course and prognosis have not been comprehensively documented and the clinical outcome remains a controversial issue. About 50% of PTC are of the classical subtype, while the other 50% are made up of less common histologic variants. 2. A rare subtype consisting of papillary projections covered by cells oncocytic in character has been defined in recent years. Medullary thyroid carcinoma. Note: it is not presently clear if oncocytic papillary renal cell carcinoma is an independent type of carcinoma or if it represents a subtype of papillary renal cell carcinoma (PRCC) 2009 Sep;37(9):671-5. doi: 10.1002/dc.21091. Very rare. This variant has also been termed as Hürthle cell variant or oxyphilic variant. Assign code 8260/3 for papillary carcinoma of thyroid. MEN IIa syndrome/MEN IIb syndrome. from surgery to recurrence of oncocytic variant of papil-lary thyroid carcinoma (OVPTC). Surgical Pathology Cancer Case Summary . 2006 Nov;19(11):1470-3. doi: 10.1038/modpathol.3800669. ... ___ Papillary carcinoma, follicular variant, encapsulated/well demarcated, with tumor capsular invasion ... ___ Follicular carcinoma, minimally invasive, oncocytic (Hürthle cell) Identification of Hürthle cells on fine-needle aspiration (FNA) of the thyroid leads to a wide differential diagnosis including benignand malignant entities. Although the cells in a NIFTP have features that look like papillary thyroid cancer, this finding alone does not mean NIFTPs are malignant. Most (95%) patients remain disease-free at four years, similar to classical PTC outcomes, suggesting that oncocytic variant may not represent a more aggressive variant. May be genetic (MEN IIa/b syndrome). Oncocytic tumours are found in the thyroid and other endocrine tissues, including the parathyroid, pituitary, adrenal cortex, pancreas, gut, and lung. The first opinion was hurthle cell tumor, encapsulated, 3.0 cm. Endocr Pathol. Mod Pathol. Barnabei A, Ferretti E, Baldelli R, Procaccini A, Spriano G, Appetecchia M. Acta Otorhinolaryngol Ital. Eosinophilic replacement infiltrates in cystic Hashimoto's thyroiditis: a potential diagnostic pitfall. In the United States, thyroid carcinoma comprises about 1% of all cancers and accounts for 0.2% of cancer deaths. The second opinion was the same except for papillary oncocytic variant. Privacy, Help 2015 Dec;26(4):286-90. doi: 10.1007/s12022-015-9386-3. Matesa-Anić D, Matesa N, Dabelić N, Kusić Z. Prasad ML, Huang Y, Pellegata NS, de la Chapelle A, Kloos RT. 2004 Jul;45(1):39-46. doi: 10.1111/j.1365-2559.2004.01876.x. The incidence of thyroid cancer, especially differentiated thyroid cancer, is increasing in developed countries. Follicular thyroid carcinoma is being diagnosed less and less frequently despite the increasing incidence of well-differentiated thyroid carcinomas everywhere. I am so confused! Because of the degree of nuclear atypia and suspicion for concurrent papillary thyroid carcinoma, a total thyroidectomy was performed revealing a papillary arrangement of Hürthle cells with classic PTC nuclear changes and associated Hashimoto's thyroiditis. We also briefly discuss the differential diagnosis and diagnostic pitfalls of Hürthle cell lesions, with a review of the literature. Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is an indolent thyroid tumor that was previously classified as an encapsulated follicular variant of papillary thyroid carcinoma, necessitating a new classification as it was recognized that encapsulated tumors without invasion have an indolent behavior, and may be over-treated if classified as a type of cancer. Bongiovanni M, Triponez F, McKee TA, Kumar N, Matthes T, Meyer P. Diagn Cytopathol. Molecular genotyping of papillary thyroid carcinoma follicular variant according to its histological subtypes (encapsulated vs infiltrative) reveals distinct BRAF and RAS mutation patterns. Oncocytes with characteristic nuclear features of PTC are seen in the thyroid aspiration cytology of this subtype. Growing The oncocytic variant of papillary carcinoma of the thyroid represents an unusual neoplasm whose clinicopathological features and biological behavior have not been thoroughly characterized. 30100 Telegraph Road, Suite 408, Bingham Farms, Michigan 48025 (USA). 3. METHODS. Cipolletta Campanile A, Malzone MG, Losito NS, Botti G, Chiofalo MG, Faggiano A, Siciliano R, Colao A, Pezzullo L, Fulciniti F. Endocr Pathol. Median node dissection done. We welcome suggestions or questions about using the website. Thyroid 4.0.0.0. Identification of Hürthle cells on fine-needle aspiration (FNA) of the thyroid leads to a wide differential diagnosis including benignand malignant entities. Oncocytic (Hürthle cell) papillary thyroid carcinoma (OPTC) is a rare variant of the papillary thyroid carcinoma (PTC) which comprises approximately 1 to 11 % of PTC cases. 2017 Sep;28(3):187-197. doi: 10.1007/s12022-017-9488-1. Papillary thyroid carcinoma (PTC) is the most common malignant tumor of the thyroid .There are approximately 15 histologic variants of PTC having variable biological behavior and prognosis .The Warthin-like variant of papillary thyroid (WLPTC) is an uncommon tumor characterized by papillae lined by large oncocytic cells with cores having dense lymphoplasmacytic infiltrate . National Library of Medicine Accuracy of Fine Needle Cytology in Histological Prediction of Papillary Thyroid Carcinoma Variants: a Prospective Study. It accounts for the majority (~70%) of all thyroid neoplasms and 85% of all 3.1. Fig 2. 2. 6. Pheochromocytoma. The prognosis for the oncocytic variant of papillary … Introduction. Prognosis is good. FOIA Pre-Tx iodine scan. Personal experience and review of the literature. Thyroid cancer is the most common malignancy in endocrine system, composed of . FNA revealed a lymphoplasmacytic infiltrate with Hürthle cells demonstrating abnormal chromatin patterns, nuclear enlargement, pleomorphism, intranuclear cytoplasmic invaginations, and foci of papillary aggregates. summarized in Table 1. The objective of this study was to assess the behavior of FVPTC, espe-cially its encapsulated form, and shed more light on its true position in the clas-sification scheme of well differentiated thyroid carcinoma. 3.2. Parathyroid adenoma. Thank you! Endocr Pathol. This report discusses cytopathological features of a rare variant of PTC (oncocytic subtype) in the background of Hashimoto's thyroiditis. Arises from C cells (which produce calcitonin). Mod Pathol. 3.3. Discussion: The oncocytic variant of papillary thyroid carcinoma can provide a diagnostic challenge, with possible differentials including oncocytic variants of follicular adenoma and carcinoma, medullary thyroid carcinoma and hyalinising trabecular tumour. The oncocytic variant of papillary carcinoma of the thyroid represents an unusual neoplasm whose clinicopathological features and biological behavior have … Unable to load your collection due to an error, Unable to load your delegates due to an error. Slightly older age at presentation (~45) 3. Contributed by Andrey Bychkov, M.D., Ph.D. oncocytic [title] "papillary carcinoma" thyroid, Lloyd: WHO Classification of Tumours of Endocrine Organs, 4th Edition, 2017, Nikiforov: Diagnostic Pathology and Molecular Genetics of the Thyroid, 3rd Edition, 2019, Tall cell variant of papillary thyroid carcinoma, Warthin-like variant of papillary thyroid carcinoma, Oncocytic variant of poorly differentiated thyroid carcinoma, Oncocytic variant of medullary thyroid carcinoma, Nodular / adenomatous hyperplasia with oncocytic metaplasia, Rare type of papillary carcinoma (PTC) characterized by nuclear features of papillary carcinoma and oncocytic / oxyphilic / Hürthle cell like cytoplasm (mitochondria-rich), Oncocytic changes can be seen in other thyroid cancer (Hürthle cell carcinoma, medullary carcinoma) and in other variants of papillary carcinoma (tall cell variant, Warthin-like variant), Papillary carcinoma with oncocytic cytoplasm, Abundant altered mitochondria on ultrastructural examination, Must differentiate from other oncocytic thyroid tumors, especially tall cell papillary thyroid carcinoma, Papillary carcinoma, Hürthle cell variant, Less than 10% of all papillary carcinomas (, < 0.5% when purely oncocytic without admixture of other patterns (, Age: 20 - 76 years, usually older than patients with conventional papillary carcinoma (, Either lobe or isthmus of thyroid gland, also in ectopic thyroid tissue, e.g., thyroglossal cyst or struma ovarii, Increasing accumulation of somatic mitochondrial DNA mutations, upregulation of energy pathways (pyruvate synthesis, Krebs cycle, electron transport chain) and mitochondrial related pathways (, Painless neck swelling or enlarged cervical lymph node, Associated with lymphocytic / Hashimoto thyroiditis in 38 - 91% (, Preoperative fine needle aspiration cytology, Histopathological examination of tumor post resection, Similar to classic papillary carcinoma on ultrasound, Well lobulated with peripheral calcifications or macrocalcification (, Recent series showed that prognosis is similar to classical papillary carcinoma, although earlier reports raised concern about poorer prognosis (, Radioactive iodine resistance has been reported (, Risk stratification as per American Thyroid Association 2015 guidelines (, 28 year old woman with lymphocytic thyroiditis (, 60 year old man with lymph node metastases (, 64 year old woman with multifocal involvement (, 70 year old woman with brain metastasis (, Usually surgical excision per American Thyroid Association and The National Comprehensive Cancer Network guidelines (, Brown in color similar to Hürthle cell tumors, Usually papillary, can be follicular, rarely solid (, Composed of oncocytic (oxyphilic, Hürthle) cells, Polygonal cells with well defined cell borders, Abundant, dense eosinophilic, granular cytoplasm, Can be discohesive, similar to Hürthle cell tumors (adenoma / carcinoma), Nuclear enlargement, round to oval nuclei, Nuclear membrane with irregular contour, nuclear grooves, frequent intranuclear pseudoinclusions, Chromatin clearing / chromatin margination / Orphan-Annie nuclei / ground glass nuclei, Prominent nucleoli, may be hidden due to above nuclear changes, Ideally should be purely oncocytic, however cut off of for proportion of oncocytic cells is not established, Monotonous population of polygonal cells arranged as sheets, clusters, papillae or single, More than 75% of cells have oncocytic changes of dense cytoplasm and well defined cell borders (, Nuclear enlargement, fine powdery chromatin, nuclear grooves, prominent intranuclear pseudoinclusions, Hürthle cells frequently demonstrate unusual staining pattern (lower intensity for, Dark and clear cells, both having abundant abnormal mitochondria (more so in dark cells), displaying stacks of parallel cristae, filamentous bundles and woolly densities (, Mitochondrial DNA mutations, especially complex I genes of the oxidative phosphorylation, are characteristic (, High prevalence of RET⁄PTC in early studies is currently debated (, Papillary thyroid carcinoma, oncocytic variant, left lobe, 1.5 cm (see synoptic report), Height of cells 2 to 3 times the cell width, has adverse prognosis, Dense lymphoplasmacytic rich infiltrate within the vascular cores, Encapsulated oncocytic tumor, round nuclei, prominent centrally placed nucleoli, cells lack well developed nuclear features of papillary thyroid carcinoma, Encapsulated oncocytic tumor with capsular or vascular invasion, round nuclei, prominent centrally placed nucleoli, Cells lack well developed nuclear features of papillary thyroid carcinoma, Increased mitotic activity of ≥ 3 mitoses per 10 high powered field, necrosis, lack of nuclear features of papillary thyroid carcinoma, Stippled chromatin, amyloid, calcitonin immunoreactivity, scattered enlarged hyperchromatic nuclei, secretory granules on ultrastructural examination, Develops in a background of lymphocytic / Hashimoto thyroiditis / adenomatous goiter, cells lack fully developed nuclear features of papillary carcinoma, Paranuclear whorls of intermediate filaments. This … Medical school memory device - 3 M's: 1. aMyloid. Epidemiology: 1. Careers. [from NCI] Sporadic tumours 1. 5. Please enable it to take advantage of the complete set of features! 2010;23(9):1191-1200.Google Scholar Crossref Definition A morphologic variant of papillary carcinoma of the thyroid gland characterized by the presence of papillary or follicular structures, containing malignant follicular cells with abundant granular eosinophilic cytoplasm. Oncocytic – The cancer cells in this type of papillary thyroid carcinoma are called oncocytic because they are larger than normal cells and look bright pink when viewed under a microscope. Typical histology of OVPTC demonstrates papillary architecture with oncocytic and nuclear features of papillary thyroid carcinoma (H & E, original ×20). of papillary thyroid carcinoma (PTC) is one entity of the vast list of differentials of which very few cases have been reported to date. 4. Identification of Hürthle cells on fine‐needle aspiration (FNA) of the thyroid leads to a wide differential diagnosis including benignand malignant entities. We report the cytological and histological findings of a patient with an oncocytic variant of papillary thyroid carcinoma (PTC) … Clipboard, Search History, and several other advanced features are temporarily unavailable. Rivera M, Ricarte-Filho J, Knauf J, et al. Cellular swirls in fine needle aspirates of papillary thyroid carcinoma: a new diagnostic criterion. roid lesions.1The oncocytic variant of papillary thyroid carci- noma (PTC) is a rare subtype accounting for 1–11% of all PTC cases, and has shown variable biological behaviour.2It is often associated with local invasion and cervical lymph node metas- Ten… 1 The minimally invasive carcinoma, also termed encapsulated, is totally surrounded by a fibrous capsule and displays capsular invasion and/or foci of vascular invasion. Hashimoto's thyroiditis with papillary thyroid carcinoma (PTC)-like nuclear alterations express molecular markers of PTC. Bethesda, MD 20894, Copyright Epub 2006 Sep 1. Outside of the endocrine system, there is an oncocytic variant of renal cell carcinoma, and salivary glands, particularly the parotid, develop oncocytic nodules and tumours. 1, 2 Most of these cancers are of the papillary type. 1. Poor prognosis. It is more common in women with an M:F ratio of 1:2.5 (range 1:1.6-3:1) 2. This website is intended for pathologists and laboratory personnel but not for patients. 2. We report the cytological and histological findings of a patient with an oncocytic variant of papillary thyroid carcinoma (PTC) with concurrent Hashimoto's thyroiditis. Their ages ranged from 20 to 76 years (average age, 48.74 years [95% CI, 43.0 Its biological behavior has been poorly Fine-needle aspiration of the diffuse sclerosing variant of papillary thyroid carcinoma masked by florid lymphocytic thyroiditis; A potential pitfall: A case report and review of the literature. Follicular carcinomas of the thyroid gland, including its oncocytic variant (so‐called Hurthle cell carcinoma), are subdivided into minimally invasive and widely invasive tumors. Prevention and treatment information (HHS). ~80% 2. 2014 Sep;25(3):332-8. doi: 10.1007/s12022-014-9304-0. © Copyright PathologyOutlines.com, Inc. Click. Papillary thyroid cancer (as is the case with follicular thyroid cancer) typically occurs in the middle-aged, with a peak incidence in the 3rd and 4th decades. Hurthle cell tumours of the thyroid. A normal human thyroid gland contains 20 to 30 million spherical follicles lined with follicular epithelial cells filled with colloid and stores a 3 months’ supply of thyroid hormone. Histopathology. Thyroid cancer is the most common endocrine neoplasia [].Papillary carcinoma thyroid (PTC) is the most common histologic type of thyroid carcinoma and has most favourable prognosis compared with that of other thyroid carcinomas [].Many variants of PTC have been described including classic, follicular, tall cell, diffuse sclerosing, solid, oncocytic, columnar cell, … Papillary thyroid microcarcinomais defined as a tumour with a maximal dimension of 1.0 cm or less. Palpable lymph nodes. Cribriform-morula variant is not listed in ICD-O-3 for papillary carcinoma. Popular - most common malignant neoplasm of the thyroid. Multiple Primaries/Histology Rule H14 states to code papillary carcinoma of the thyroid to papillary adenocarcinoma, NOS (8260). 10 Conventional, or classical, papillary thyroid carcinoma (C-PTC), seen below, is characterized by papillary architecture with fibrovascular cores (black arrows) and psammoma bodies (yellow arrows) and tumor cells containing enlarged, overlapping nuclei (yellow box) with nuclear … 2. Coexistence of papillary carcinoma and Hashimoto's thyroiditis. No LN involvement w/clear margins.
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