Cytomorphology and immunocytochemistry of columnar cell variant of papillary thyroid carcinoma

Abstract

and experience in general cytopathology whereas about half said that in practice they did not. What is the answer? Clinical specialisation is a reality and has to be accommodated; everyone can not become an expert in everything. | A PROPOSED SOLUTION FOR GENERAL AND SPECIALIST CYTOPATHOLOGYThe answer for cytopathology is to take on the European principle of the 'common trunk' and teach cytology along with histology from the earliest opportunity. Medical students should see both when learning about basic concepts of microscopy in normal, benign and malignant conditions; attendance at multidisciplinary meetings gives them the opportunity to place microscopic appearances in a clinical context; familiarity with cytology from an early stage and up to the FRCPath Part 2 examination would enable them to enjoy recognizing the elegance of the cytology of normal structures and the specificity of the cytology of many tumours and lesions.Post-FRCPath trainees should be expected to spend time working in centres with high standards of cytopathology in their chosen clinical speciality or specialities. They need not report both when they become consultants: they may either report cytopathology in general and histopathology as a specialist subject or report both (or one or other) in one or more clinical specialities. With all these options basic training in cytopathology alongside histopathology would allow pathologists in all specialities, including gynaecological pathology, either to develop their own expertise in cytopathology or to make sure that others in their departments do so.In the absence of a Diploma in Cytopathology there is no provision for trainees to demonstrate a commitment to cytology. Perhaps they should be encouraged to take an MD in a cytology-related topic-bearing in mind that without an MD pathology qualifications are incomplete in many countries (including the USA and India).Added to a final College examination that need not include cervical cytopathology pathology trainees are likely to become isolated from the world at large as well as from the rest of Europe-but conforming to the UEMS guidelines would at least avoid Brexit meaning Brexit for our trainees.

Curious Residents of the Thyroid Gland: Two Case Reports of Colorectal Carcinoma Metastasis by Fine-Needle Aspiration Diagnosis

“…However, metastatic colorectal adenocarcinoma can be very similar to the tall cell or columnar cell variant of papillary thyroid carcinoma [11,12]. In the tall cell variant, the nuclei can be less powdery and more granular than in conventional type papillary thyroid carcinoma, but intranuclear cytoplasmic pseudoinclusions are more common.…”

“…In the columnar cell variant, the nuclei are frequently hyperchromatic with a low frequency of the typical nuclear grooves and intranuclear cytoplasmic pseudoinclusions. The nuclei are often elongated and can show pseudostratification [12]. Necrotic debris is uncommon in papillary thyroid carcinoma but often present in metastatic colorectal adenocarcinoma.…”

“…Immunocytochemical stains for CK20, CEA, TTF-1 and thyroglobulin can be of help in the differential diagnosis [4,12]. Also, mutations in KRAS codon 12 and 13 are helpful to confirm the diagnosis of metastatic colorectal adenocarcinoma [4].…”

Columnar Cell Variant of Papillary Thyroid Carcinoma: A Clinicopathologic Analystis

“…The expression of CDX2 was about 55%, while low expression in other types of thyroid cancer. [9,10].…”

Current Status of Thyroid Fine-Needle Aspiration Practice in Thailand

“…Immunostaining in thyroid pathology, either surgical or cytopathology, is not much used because of its insufficient accuracy in distinguishing benign from malignant follicular-patterned lesions and other limitations [ 15 , 16 ]. Immunocytochemistry on cell blocks is infrequently employed for differential diagnosis of certain malignancies, such as papillary carcinoma (thyroid transcription factor 1 [TTF-1], thyroglobulin), medullary carcinoma (TTF-1, calcitonin, carcinoembryonic antigen), and metastatic adenocarcinoma (cytokeratin 7, CDX2) [ 17 ].…”