These are the scarred remnants of tumor papillae that presumably infarcted. Non-tumour-associated psammoma bodies in the thyroid. Although ground glass appearance, nuclear crowding, and nuclear grooving are not pathognomonic of PTC, presence of more than one feature is highly indicative of PTC, hence the need for detailed study. Am J Surg Pathol 1993;17:1067-8. Philadelphia: Elsevier; 2007. p. 997-1081. nuclear grooves Am J Clin Pathol 1992;97:426-1. 3. Hurthle / Oxyphilic variant:- cellular features of Hürthle cell carcinomas but cells that are arranged in papillary formations. If playback doesn't … Am J Clin Pathol 2003;119:90-4. Background: Follicular thyroid carcinoma (FTC) is the second most common thyroid malignancy after papillary thyroid carcinoma. While papillary thyroid carcinoma tends to have an excellent prognosis, certain histologic variants have been shown to have more aggressive clinical courses. Cancer J 2006;12:275-82. a noninvasive, encapsulated, well-circumscribed subtype (NI-FVPTC) – frequently have the RAS mutations, an invasive subtype with either invasion (capsular or vascular invasion) or lacking a well-defined capsule (diffuse/multinodular) – often harbor BRAF V600E mutations, Prognosis similar to conventional PTC except for diffuse-type which have an aggressive course. A useful diagnostic criterion of papillary carcinoma of the thyroid. Oncocytic variant should show the morphology in more than or equal to 75% while hobnail variant should have hobnailed nuclei in more than or equal to 30%. It occurs more frequently in women and presents in the 20–55 year age group. NOTE: For thyroid cancer only, the term micropapillary does not refer to a specific histologic type. 5. Virchows Arch 1989;414:91-104. Settings and Design: Among the thyroidectomy specimens received in the department of pathology, only the PTC cases were chosen. Follicular neoplasms of the thyroid: View, biases, and experiences. Dataset for thyroid cancer histopathology reports. Non-encapsulated, those with extensive sclerosis and having BRAF mutations are more aggressive with comparatively poor prognosis. Macrofollicular variant of papillary thyroid carcinoma (MFV-PTC) was described in 1991 by Albores-Saavedra et al [].It is a rare variant of papillary carcinoma with a frequency of 2.6% [], characterized by highly dilated thyroid follicles in more than 50% of the neoplasm and resembles thyroid adenoma or nodular colloid goiter.Most have a good prognosis and are … Papillary thyroid carcinoma is a type of thyroid cancer. PopUp = window.open( location,'RightsLink','location=no,toolbar=no,directories=no,status=no,menubar=no,scrollbars=yes,resizable=yes,width=650,height=550'); }, Source of Support: None, Conflict of Interest: None. Chan JK. In addition to papillary architecture, nuclear features like clear, ground glass or Orphan Annie-eyed appearance, oval shape, increased nuclear size, hypodense chromatin, intranuclear cytoplasmic inclusions, nuclear grooving, nuclear overlapping, and mitotic figures play a vital role in the diagnosis although some of the features may be seen in other diseases of thyroid. Results: The study evaluated that the ground glass nuclei, nuclear grooving, and nuclear overcrowding were the most common features seen in all (100%) cases though percentage of cells exhibiting these features varied from tumor to tumor. Papillary thyroid carcinoma: An overview. Shows a BRAF mutation more often (35–70%). Classical or non-other-wise specified (NOS) papillary carcinoma is characte-rized by the formation of papillae and a set of distincti-ve nuclear features (optically clear appearance, over- Oyama T. A histopathological, immunohistochemical and ultrastructural study of intranuclear cytoplasmic inclusions inthyroid papillary carcinoma. Answer . 2. An extra-thyroidal extension is more common. Arch Pathol Lab Med 2006;130:1057-62. Your email address will not be published. Papillary thyroid carcinoma is the most common type of cancer to affect your thyroid -- a butterfly-shaped gland that sits just below your … Microscopically shows sheets of tumor cells, which have cytological features of conventional PTC – mimics a solid type of poorly differentiated carcinoma. He has got around 10+ publications in various national and international peer reviewed journals. We investigated tumor aggressiveness with respect to tumor margin histology in patients with papillary thyroid carcinoma (PTC). It is also the predominant cancer type in children with thyroid cancer, and in patients with thyroid cancer who have had previous radiation to the head and neck. Histopathological features of Papillary Thyroid Carcinoma with special emphasis on the significance of nuclear features in their diagnosis Microscopically shows darker or hypereosinophilic colloid, with occasional multinucleated giant cells within the follicles. Keywords: Nuclear features, papillary carcinoma, variants, https://www.amhsjournal.org/text.asp?2014/2/1/16/133786. Use the Multiple Primary and Histology Coding Rules Manual for cases diagnosed 2007 or later to determine the number of primaries. Lloyd RV, Buehler D, Khanafshar E. Papillary thyroid carcinoma variants. The authors studied the clinical course of 132 patients with FTC to determine whether there was a direct relation between the histologic degree of invasion, tumor recurrence, and patient survival. the most common form of well-differentiated thyroid cancer, and the most common form of thyroid cancer to result from exposure to radiation. Tumor cells have abundant eosinophilic cytoplasm, necrosis, mitotic activity and nuclear features similar to conventional papillary carcinoma. 1 reported “tumor cellularity,” arrangement in empty follicles, … Al-BrahimN. Often diagnosed as follicular neoplasm in fine needle cytology. Tumors of thyroid and parathyroid glands. A.1.3. Papillary carcinoma thyroid (PTC) is the most common differentiated malignancy of thyroid gland. Papillary thyroid carcinoma develops from the follicular cells normally found in the thyroid gland. Prognosis is good. This cancer is named after the small finger-like projections of tissue called papilla that are seen in some tumours. Papillary thyroid carcinoma cases with the topographic identifier C73 and with known histologic grade were extracted using the following ICD-O-3 histology codes: papillary carcinoma NOS (8050), papillary carcinoma of thyroid (8260), follicular variant of PTC (8340), papillary microcarcinoma (8341), encapsulated papillary carcinoma (8343) (Fig. The aggressive behavior has been ascribed to the histologic subtype and/or to the clinicopathologic features, an issue that remains controversial. Papillary thyroid cancer (carcinoma) can occur in people of all ages from early childhood to advanced ages although it is most common in people between age 30 and 50. “Psamomma bodies” with concentric lamellae composed partly of thyroglobulin are more common in approximately 50% of papillary carcinoma thyroid. Papillary Thyroid Carcinoma with Fasciitis-like Stroma:- rare variants of PTC associated with fasciitis like stroma or fibromatosis-like stroma, which mimics PTC with de-differentiation to anaplastic carcinoma. Diagnosis of follicular variant (FV) of papillary carcinoma (PC) of the thyroid is considered difficult on cytology. Background: Papillary carcinoma (PTC) is the most common thyroid malignancy comprising 80-85%. tumor cells containing large, oval, crowded and overlapping nuclei with nuclear clearing (“Orphan Annie cells”) and nuclear grooves and nuclear membrane irregularities. Watch later. In any of suspected cases of PTC, a detailed study of tissues should be performed to evaluate PTC-like nuclear features like ground glass appearance, nuclear crowding, and nuclear grooving for confirmation of diagnosis. London: The Royal College of Pathologists, 2014. He did his graduation from Cochin University of Science and Technology (CUSAT) in 2010, and pursued his masters in oto-rhino-laryngology from Sri Siddhartha Academy of Higher Education, Tumkur, Karnataka, India in 2017. Other features mentioned above were less frequently encountered (42%-95%). The nuclei of papillary cancer have been described as clear, ground glass, empty, or Orphan Annie eyed. Depending on the different histopathological patterns, cell types and clinical features different variants of papillary carcinoma thyroid have been described. Tap to unmute. Baloch ZW, LiVolsi VA. Cytologic and architectural mimics of papillary thyroid carcinoma. Diagnostic Histopathology of Tumors. 1. About 50% of PTC are of the conventional subtype, while the other 50% is made up of less common histologic variants. Hunt JL, Barnes EL. Diagn Histopathol 2016;22;171–178. Am J Clin Pathol 2002;117:16-8. Multinucleated histiocytes in the lumen of the follicles. 5. Adv Anat Pathol 2004;11:279-87. Chen H, Izevbaye I, Chen F, Weinstein B. Hum Pathol 1987;18:1252-5. ..... read more.. Shamblin classification of carotid body tumors, Subglottic Stenosis – Clinical Features and Treatment, Sudden Sensorineural Hearing Loss (SSNHL) – Clinical presentation, Diagnosis and Treatment, Inverted Papilloma – Clinical features, Diagnosis and Treatment, TNM Staging of Oropharyngeal Cancer – Updates in AJCC 8th Edition. Dear Cynthia. This is a single primary. Journal of Evolution of Medical and Dental Sciences. LiVolsi VA, Baloch ZW. 4. Am J Clin Pathol 2006;125:135-44. The “Warthin-like” oncocytic variant has abundant lymphocytic stromal infiltrate and is often seen with Hashimoto’s thyroiditis. Present with large bulky tumors which are usually larger and aggressive than conventional PCT. The tall cell variant of papillary thyroid carcinoma is the most common aggressive variant of papillary thyroid carcinoma. Turk Patoloji Derg 2015;31:34-47. Statistical analysis: Fischer's exact test was done to find the correlation between the grading of nuclear features and cell population. Depending on the different histopathological patterns, ... About 50% of PTC are of the conventional subtype, while the other 50% is made up of less common histologic variants. Predominantly elongated and unevenly shaped follicles. Crowding of nuclei with lack of polarity, Clear nuclear chromatin pattern or prominent nuclear grooves, and. He has subspecialty interests in paediatric otorhinolaryngology and received his training from Department of Pediatric ENT, Christian Medical College Hospital, Vellore, Tamilnadu, India. 85% of all thyroid cancers ; female dominance; often multifocal; risk factors include radiation exposure to the head and neck; spreads via lymphatics; very good prognosis; histology psammoma bodies (calcifications) also seen in ovarian papillary serous cystadenocarcinoma and meningiomas; ground glass/empty nuclei . Deepa Thomas Kunjumon, Krishnaraj Upadhyaya Papillary and follicular thyroid cancer K. A. Ikram Hussain Final year M.B.B.S. Histological features, such as vascular and/or lymphatic invasion, … Immunostaining for TTF-1 and thyroglobulin may be necessary to distinguish these tumors from a clear cell carcinoma of other organs such as the kidney or colon that have metastasized to the thyroid. Am J Surg Pathol 1986;10:672-9. Conclusion: In PTC, especially in variants, nuclear features are of utmost importance as they have to be differentiated from other thyroid diseases presenting with similar architectural morphology. Typically associated with familial adenomatous polyposis and Gardner Syndrome (APC Mutations). Notes: 1. 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. Cancer 2003;97:1181-5. Dr Sanu P Moideen is an Indian-born oto-rhino-laryngologist (ENT) based in Cochin, Kerala, India. A report of 2 cases of an aggressive variant of thyroid carcinoma. Zidan J, Karen D, Stein M, Rosenblatt E, Basher W, Kuten A. It is the most common thyroid cancer in adults. Papillary thyroid carcinoma is the most common thyroid malignancy, and has an excellent prognosis, even with cervical lymph node metastasis; however, histological variants are considered relevant, which may be associated with familial adenomatous polyposis and tumor aggressiveness. The authors recommend that all papillary carcinomas be given a histologic grade based on a combined examination of nuclear atypia, tumor necrosis, and vascular invasion. Am J Clin Pathol 2008;130:683-86. There is wide heterogeneity in the frequency and clinical behaviour of the major histological subtypes of thyroid cancer, from common and mostly asymptomatic papillary tumours, to larger and more advanced papillary tumours, 5 and to rare but highly aggressive and rapidly lethal anaplastic malignancies. Conventional PTC has an excellent prognosis. It means that the papillary portion of the tumor is minimal or occult. Strict criteria should be applied in the diagnosis of encapsulated follicular variant of papillary thyroid carcinoma. the case with follicular thyroid cancer) typically occurs in the middle-aged Evans HL. Popular - most common malignant neoplasm of the thyroid. This is not a specific variant but includes all PTC which are usually found incidentally and measure less than 1 cm in diameter. Five hundred fourteen consecutive patients who underwent surgery for primary PTC between January and July 2009 were assigned to two groups, one with an infiltrative pattern (I-type, n = 347) at tumor margins and one with an expanding pattern (E … A number of histologic variants of well-differentiated papillary carcinoma have been found to be associated with more aggressive tumor behavior. overview. PTC is associated with radiation exposure. Some tumors may show squamous metaplasia and some may contain multinucleated giant cells also. Because of the better prognosis and non-invasive nature, NI-FVPTC is renamed as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFT-P tumors). Combined Papillary Thyroid Carcinoma and Medullary Thyroid Carcinoma:- consists of separate areas or cells with PTC or medullary thyroid carcinoma, Papillary Thyroid Carcinoma with Dedifferentiation to Anaplastic Carcinoma:- PTC can undergo dedifferentiation or transformation to anaplastic carcinoma. For diagnosis of all variants of papillary carcinoma, except oncocytic and hobnail, microscopically it should have more than 50% of tumors showing their unique patterns along with nuclear features. An analysis of aggressive papillary thyroid carcinoma (PTC) subtypes indicated that treatment of these variants should be tailored to the specific histologic subtypes present. LiVolsi VA. Papillary neoplasms of the thyroid-pathologic and prognostic features. Papillary . Hence, more tissue sections have to be screened. Histopathology Thyroid --Papillary carcinoma.
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