Fine needle aspiration cytology features of poorly differentiated thyroid carcinoma

Purkait, Suvendu; Agarwal, Shipra; Mathur, Sandeep; Jain, Deepali; Iyer, V. K.

doi:10.1111/cyt.12270

Cited by 25 publications

(30 citation statements)

References 15 publications

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“…Despite attempts by some groups, there are no universally accepted cytological criteria for the diagnosis of PDTC that can be applied to thyroid FNA material. This is unfortunate because the preoperative identification of PDTC could lead in many cases to a more aggressive initial management of these patients: in fact, in the frame of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), PDTC is often classified as a follicular lesion (diagnostic category IV, FN/SFN), which entails a surgical lobectomy …”

Section: Cytological Features Of Pdtcmentioning

confidence: 99%

“…When these cytological studies are considered together, insular or solid patterns and high cellularity emerge as the most common cytological features as emphasised by all four studies . Single cell pattern, high N/C ratio, granular chromatin and mitotic activity were described in different combinations by three of the four series.…”

Section: Cytological Features Of Pdtcmentioning

confidence: 99%

“…Single cell pattern, high N/C ratio, granular chromatin and mitotic activity were described in different combinations by three of the four series. Endothelial wrapping of cell clusters, scant cytoplasm, nuclear pleomorphism, nuclear crowding/overlapping and apoptosis were less frequently reported (Table ; Figure ) . A few recent case reports have contributed to the literature on the topic.…”

Section: Cytological Features Of Pdtcmentioning

confidence: 99%

“…The recognition of PDTC as a distinct entity and the introduction of better defined histomorphological criteria facilitated a uniform diagnostic approach for pathologists; however, the cytological diagnosis of PDTC remains problematic . In various studies, approximately one fourth of all PDTC aspirations were reported as malignant but classified as WDTC, and one third were reported as follicular neoplasm/suspicious for a follicular neoplasm (FN/SFN); such may lead to a less extensive initial procedure (notably lobectomy instead of total thyroidectomy), necessitating additional surgery (i.e., completion thyroidectomy with or without lymph node dissection) …”

Section: Introductionmentioning

confidence: 99%

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FNA diagnosis of poorly differentiated thyroid carcinoma. A review of the recent literature

et al. 2017

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Poorly differentiated thyroid carcinoma (PDTC) is a follicular cell-derived tumour that was recognised as a distinct entity by the World Health Organisation in 2004. The natural history and pathological features of PDTC are reported to be intermediate between those of well-differentiated and undifferentiated (anaplastic) thyroid carcinomas. Preoperative identification of PDTC could facilitate better initial patient management in many cases, namely more extensive surgery, without any delay. However, according to some experts, a diagnosis of PDTC can only be rendered on histologic specimens based on criteria recommended in the Turin proposal. Although high-grade features (namely necrosis and mitoses) can be recognised in FNA material, other cytomorphological features have limited value for the preoperative diagnosis of PDTC and specific features for a definitive diagnosis of PDTC have not yet been clearly defined. Here, we review the current status and future prospects for cytological recognition of PDTC; we emphasise the features that should raise suspicion of this rare condition in FNA cytology and provide an update on molecular features and management of PDTC. Despite proposed histological criteria for the diagnosis of PDTC, its recognition on routine thyroid cytology presents a notable challenge. Current and future advances in molecular testing could contribute to the cytological diagnosis of PDTC.

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Section: Cytological Features Of Pdtcmentioning

confidence: 99%

Section: Cytological Features Of Pdtcmentioning

confidence: 99%

Section: Cytological Features Of Pdtcmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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FNA diagnosis of poorly differentiated thyroid carcinoma. A review of the recent literature

et al. 2017

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“…The cytological features of SVPTC were compared with PDTC, which is a close morphological differential of SVPTC [14], and with commoner PTC variants, i.e., classical PTC (cPTC), including cPTC showing follicle predominance (PTC-FP), and with NIFTP/follicular variant of PTC (FVPTC). For this, all PDTC cases diagnosed over the same period with available FNA smears were included.…”

Section: Methodsmentioning

confidence: 99%

Cytopathology of Solid Variant of Papillary Thyroid Carcinoma: Differential Diagnoses with other Thyroid Tumors

et al. 2018

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Objectives: Solid variant of papillary thyroid carcinoma (SVPTC) is rare, differing from classical PTC (cPTC) in architecture and outcome. We evaluated the cytomorphology of SVPTC cases to assess the feasibility of a preoperative diagnosis. Study Design: SVPTC cases were evaluated for architecture, nuclear features, and Bethesda category and were compared with noninvasive follicular thyroid neoplasm with papillary-like nuclear features/follicular variant of PTC (NIFTP/FVPTC), cPTC, and poorly differentiated thyroid carcinoma (PDTC). Results: Nine SVPTCs, 29 NIFTP/FVPTCs, 12 cPTCs, and 4 PDTCs were included. The predominant architecture in most SVPTCs was solid fragment, which is helpful in differentiating them from NIFTP/FVPTC (p < 0.001) and cPTC (p = 0.006) but not from PDTC. The presence of microfollicles led to misinterpretation as NIFTP/FVPTC/follicular neoplasm in 4 patients. All but 1 SVPTC showed diffuse nuclear features. Intranuclear pseudoinclusions (INIs) were seen in 67% of SVPTCs as compared to 83% of cPTCs, 14% of NIFTP/FVPTCs (p = 0.005), and none of PDTCs. SVPTC cases were commonly (78%) categorized as intermediate/suspicious. Conclusions: The presence of solid fragments and lack of true papillae are helpful in differentiating SVPTC from cPTC. Solid fragments, trabeculae, the extent of nuclear features, and INIs should be looked for in cases with prominent microfollicles for distinguishing SVPTC from NIFTP/FVPTC. None of the features were helpful in differentiating SVPTC from PDTC.

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Cytologic features of aggressive variants of follicular‐derived thyroid carcinoma

Rossi

Faquin

Pantanowitz

2019

Cancer Cytopathology

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Certain carcinomas of the thyroid gland behave aggressively resulting in increased patient morbidity and poor patient prognosis. The diagnosis of these aggressive thyroid cancer subtypes is sometimes challenging and subject to increased interobserver variability. This review deals with the cytological features of such tumors including aggressive variants of papillary thyroid carcinoma, poorly differentiated thyroid carcinoma, and anaplastic thyroid carcinoma. These malignancies fall into 2 groups based on their cytomorphology: those that exhibit distinct microscopic features (eg, nuclear findings typical of classical papillary thyroid carcinoma or marked anaplasia) and those that present with more subtle cytologic features (eg, nuclear pseudostratification, “soap bubble” nuclei, supranuclear or subnuclear cytoplasmic vacuoles, rosette‐like structures, hobnail cells). We review the literature regarding these aggressive thyroid cancers and highlight important phenotypic characteristics that can be useful for their diagnosis based on fine needle aspiration.

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Fine needle aspiration cytology features of poorly differentiated thyroid carcinoma

Abstract: Although PDTC has considerable cytomorphological overlap with well-differentiated thyroid tumours, this present study highlights certain cytomorphological features that may suggest the correct pre-operative diagnosis, important for the appropriate management.

Cited by 25 publications

References 15 publications

FNA diagnosis of poorly differentiated thyroid carcinoma. A review of the recent literature

FNA diagnosis of poorly differentiated thyroid carcinoma. A review of the recent literature

Cytopathology of Solid Variant of Papillary Thyroid Carcinoma: Differential Diagnoses with other Thyroid Tumors

Cytologic features of aggressive variants of follicular‐derived thyroid carcinoma

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