Macrofollicular Encapsulated Variant of Papillary Thyroid Carcinoma as a Potential Pitfall in Histologic and Cytologic Diagnosis

Fadda, Guido; Fiorino, Marilena; Mulè, Antonino; LiVolsi, Virginia A.

doi:10.1159/000326877

Cited by 19 publications

(9 citation statements)

References 12 publications

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“…All 5 patients survived with no evidence of carcinoma recurrence on long-term follow-up (145-225 months), which is thought to be because this variant lacks the prominent clinicopathological features that adversely affect prognosis. Previous studies from Western countries have also shown a good prognosis for this variant [2, [4][5][6][7][8]. However, cases demonstrating palpable lymph node metastasis, recurrence to the lung and locoregional recurrence with anaplastic transformation have also been reported [2, 4,5], indicating that the macrofollicular variant in Japan is possibly more indolent than that in Western countries.…”

Section: Discussionmentioning

confidence: 99%

Macrofollicular Variant of Papillary Thyroid Carcinoma: Its Clinicopathological Features and Long-Term Prognosis

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Macrofollicular Variant of Papillary Thyroid Carcinoma: Its Clinicopathological Features and Long-Term Prognosis

et al. 2009

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“…Although most of these earlier papers described the presence of moderate to abundant colloid and moderate cellularity, the cases reported by Fadda et al ., described small amount of colloid, scant cellularity, medium to large sized follicular cells with some clearing but no nuclear grooves or intranuclear inclusions. [5] Three cases reported by Lugli et al ., described presence of nuclear grooves and ground glass chromatin in 2 of their 3 cases. One of their cases had no cytologic features of papillary carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…However, the macrofollicular variant of papillary thyroid carcinoma (MFVPTC) is a potential pitfall given the rarity of this histologic subtype and limited reports of its cytologic features. [12345678] The presence of abundant watery colloid, low to moderate cellularity, syncytial to monolayered cell arrangement, subtle and focal nuclear features associated with papillary carcinoma can lead to an erroneous diagnosis of an adenomatoid/colloid nodule or a follicular neoplasm (macrofollicular type). We report two cases of macrofollicular variant of papillary carcinoma (MFPC) and a review of the literature.…”

Section: Introductionmentioning

confidence: 99%

Macrofollicular variant of papillary carcinoma, a potential diagnostic pitfall: A report of two cases including a review of literature

Policarpio‐Nicolas

Sirohi

2013

CytoJournal

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Macrofollicular variant of papillary thyroid carcinoma (MFVPTC) is one of the rarest histologic types of papillary carcinoma. This tumor may mimic an adenomatoid/colloid nodule or follicular neoplasm (macrofollicular type) both on histology and cytology. There are very few articles describing the cytologic features of MFVPTC. We report the cytologic findings of two surgically confirmed MFVPTC. The first case showed abundant thin colloid with moderate amount of follicular cells arranged in a honeycombed and syncytial pattern. Some but not all the follicular cells showed enlarged round to ovoid nuclei, overlapping nuclei, few nuclear grooves and rare intranuclear inclusions. The second case showed abundant thin colloid and predominantly benign appearing follicular cells with few overlapping nuclei, enlarged round to ovoid nuclei and rare nuclear grooves. No intranuclear inclusions were identified. A review of the literature was done and the cytologic findings of MFVPTC including our two cases were tabulated. The cytologic findings showed moderate to abundant thin with focally thick colloid in 75% of cases and sheet like arrangement of follicular cells in 76%. Although nuclear features such as chromatin clearing, overlapping and grooves were present in majority of cases, the quantity varied from rare to focal. Small to prominent nucleoli were present in all of the evaluable cases. Intranuclear inclusions were seen only in 45% of patients. Hence, the cytologic features of macrofollicular variant of papillary carcinoma though present can be subtle and intranuclear inclusions may not be present always.

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“…The known cytologic diagnoses that were given for the reported MFV cases were: PTC ( n = 13), benign ( n = 10), AUS/FLUS ( n = 7), and FN/SFN ( n = 5) . The cytologic features of MFV, which have rarely been described, are neither sensitive nor specific . At low magnification, MFV can be easily overlooked as a benign nodule due to the often abundant thin and focally thick colloid (75% of cases) and sheet‐like arrangement of follicular cells (76% of cases) with subtle and patchy nuclear atypia (Fig.…”

Section: Macrofollicular Variantmentioning

confidence: 99%

“…At low magnification, MFV can be easily overlooked as a benign nodule due to the often abundant thin and focally thick colloid (75% of cases) and sheet‐like arrangement of follicular cells (76% of cases) with subtle and patchy nuclear atypia (Fig. ) . At higher magnification, the neoplastic cells usually have round to ovoid nuclei, small eccentric to conspicuous nucleoli, chromatin pallor, nuclear overlapping and nuclear grooves .…”

Section: Macrofollicular Variantmentioning

confidence: 99%

Update on the cytologic features of papillary thyroid carcinoma variants

Pusztaszeri

Auger

2017

Diagnostic Cytopathology

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Papillary thyroid cancer (PTC), which accounts for 85-90% of all thyroid cancers, is generally an indolent tumor with long term survival rates >95%. A reliable definitive diagnosis of PTC is usually straightforward in fine needle aspirates of conventional PTC whenever the characteristic papillary and/or flat honeycomb sheet-like architecture and the typical nuclear features of chromatin pallor, nuclear enlargement, crowding, grooves and pseudoinclusions are encountered. Conventional PTC, however, has diminished in relative frequency as compared to PTC variants, especially the noninvasive follicular variant of PTC, an indolent tumor which has recently been reclassified as "noninvasive follicular thyroid neoplasm with papillary-like nuclear features" (NIFTP). These PTC variants are characterized by various architecture, cell type and shape, and stromal features, some of which can be recognized cytologically. Awareness of the cytomorphological spectrum and of the characteristic cytological features of these PTC variants is important to avoid diagnostic pitfalls. In this article, we review the different variants of PTC, including their cytomorphologic features, differential diagnosis, and salient molecular features. Diagn. Cytopathol. 2017;45:714-730. © 2017 Wiley Periodicals, Inc.

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Macrofollicular Encapsulated Variant of Papillary Thyroid Carcinoma as a Potential Pitfall in Histologic and Cytologic Diagnosis

Cited by 19 publications

References 12 publications

Macrofollicular Variant of Papillary Thyroid Carcinoma: Its Clinicopathological Features and Long-Term Prognosis

Macrofollicular Variant of Papillary Thyroid Carcinoma: Its Clinicopathological Features and Long-Term Prognosis

Macrofollicular variant of papillary carcinoma, a potential diagnostic pitfall: A report of two cases including a review of literature

Update on the cytologic features of papillary thyroid carcinoma variants

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