Papillary Carcinoma Tall Cell Variant (TCV): A Review

LiVolsi, Virginia A.

doi:10.1007/s12022-010-9106-y

Cited by 72 publications

(82 citation statements)

References 19 publications

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“…The TCV PTC is a distinct entity of thyroid tumors that is associated with an unfavorable patient outcome. The threshold of proportion of TCs in a given carcinoma to allow for the diagnosis of TCV is poorly defined and differs in the literature from no information at all to 10-75% (Sobrinho-Simoes et al 1989, Ostrowski & Merino 1996, Akslen & LiVolsi 2000, DeLellis et al 2004, LiVolsi 2010. Our results confirm that PTCs comprising more than 50% TCs have an ACO.…”

Section: Discussionsupporting

confidence: 56%

“…Previous clinicopathological studies on TCV PTC analyzed small groups of tumors with ACO, which thereby limited their statistical power (Ostrowski & Merino 1996, LiVolsi 2010. In this study, the number of patients with ACO was increased to a relatively large sample size via the identification of patients in nuclear medicine departments.…”

Section: Discussionmentioning

confidence: 98%

“…Among the different PTC subtypes, the tall cell variant (TCV) is known to have a more aggressive clinical behavior (LiVolsi 2010). However, the morphological criteria for the diagnosis of this entity is not clearly defined by the WHO ('The TCV is composed predominantly of cells whose heights are at least three times their widths.…”

Section: Introductionmentioning

confidence: 99%

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Tall cell papillary thyroid carcinoma: new diagnostic criteria and mutations in BRAF and TERT

Dettmer¹,

Schmitt²,

Steinert³

et al. 2015

Endocrine-Related Cancer

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The tall cell (TC) variant of papillary thyroid carcinoma (PTC) has an unfavorable prognosis. The diagnostic criteria remain inconsistent, and the role of a minor TC component is unclear. Molecular diagnostic markers are not available; however, there are two potential candidates: BRAF V600E and telomerase reverse transcriptase (TERT) promoter mutations. Using a novel approach, we enriched a collective with PTCs that harbored an adverse outcome, which overcame the limited statistical power of most studies. This enabled us to review 125 PTC patients, 57 of which had an adverse outcome. The proportion of TCs that constituted a poor prognosis was assessed. All of the tumors underwent sequencing for TERT promoter and BRAF V600E mutational status and were stained with an antibody to detect the BRAF V600E mutation. A 10% cutoff for TCs was significantly associated with advanced tumor stage and lymph node metastasis. Multivariate analysis showed that TCs above 10% were the only significant factor for overall, tumor-specific, and relapse-free survival. Seven percent of the cases had a TERT promoter mutation, whereas 61% demonstrated a BRAF mutation. The presence of TC was significantly associated with TERT promoter and BRAF mutations. TERT predicted highly significant tumor relapse (P!0.001). PTCs comprised of at least 10% TCs are associated with an adverse clinical outcome and should be reported accordingly. BRAF did not influence patient outcome. Nevertheless, a positive status should encourage the search for TCs. TERT promoter mutations are a strong predictor of tumor relapse, but their role as a surrogate marker for TCs is limited.

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Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 98%

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Tall cell papillary thyroid carcinoma: new diagnostic criteria and mutations in BRAF and TERT

Dettmer¹,

Schmitt²,

Steinert³

et al. 2015

Endocrine-Related Cancer

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“…This confusion may affect the prognosis or the prevalence of the tall cell variant because conventional papillary thyroid carcinoma can also have a minor component with tall cell cytologic characteristics. 19 Although a multicenter study of the tall cell variant by the Korean Society of Thyroid Radiology was announced, only 3 hospitals with a total of 10 cases participated in the study. This limited participation may account for the rarity of the disease, unclassified variants at the time of pathologic diagnosis, and the strict criteria for this study.…”

Section: Discussionmentioning

confidence: 99%

Tall Cell Variant of Papillary Thyroid Carcinoma

Choi

Shin

Kim

et al. 2011

Journal of Ultrasound in Medicine

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apillary thyroid carcinoma, the most common form of thyroid carcinoma (85% of cases), is well known for its indolent clinical behavior with a high survival rate compared to those of other malignancies. When papillary thyroid carcinoma with frequent recurrences and distant metastasis with aggressive clinical behavior is encountered, it has been pathologically diagnosed as a variant. 1-3 Among the variants of papillary thyroid carcinoma, the tall cell variant frequently has lymph node metastasis, distant metastasis, or both, with a strong association with a poorer prognosis, 4-12 behaving very differently from indolent or conventional papillary thyroid carcinoma.The definition of the tall cell variant of papillary thyroid carcinoma was first proposed by Hawk and Hazard 13 as the presence of a papillary tumor whose cells are at least twice as long (tall) as they were wide. Since then, other pathologists have proposed more stringent criteria to diagnose the tall cell variant, including a composition of more than 50% tall cells, with a tall cell height of at least twice the width, eosinophilic tall cell cytoplasm, and nuclear features characteristic of papillary thyroid carcinoma. 14 This subtype, which constitutes less than 5% of all papillary thyroid carcinomas, 15 had not been studied much because of its rarity and difficult diagnosis, even with its aggressive clinical features and high mortality rates.A study performed in Japan suggested that an unidentified endemic factor is responsible for the lower prevalence and independent poor prognostic factors of the tall cell variant. 7 The aims of this series were to describe the clinical characteristics of the tall cell variant of papillary thyroid carcinoma and to characterize its highresolution sonographic features. Medicine, CASE SERIESWe retrospectively reviewed the clinical and sonographic features of 8 patients with 10 tall cell variants of papillary thyroid carcinoma. The mean age of the patients was 57 years (range, 34-72 years). The tumor sizes varied. Of the 8 patients, 5 had symptomatic masses, and 3 had incidentalomas. Three patients had recurrences and 1 died of pulmonary metastasis within a mean time of 30 months. The tall cell variants often appeared as microlobulated markedly hypoechoic nodules with microcalcifications and extrathyroidal extension on sonography and were always associated with lymph node metastasis. The tall cell variant of papillary thyroid carcinoma should be included in the differential diagnosis of an aggressive thyroid tumor with symptoms and cervical nodal metastasis.

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“…Around 2005, we also adopted the terminologies proposed by the Chernobyl pathology group (Williams, 2000) for difficult cases of thyroid carcinoma: Well differentiated tumor of uncertain malignant potential (WDT-UMP) for papillary carcinoma (follicular variant); Follicular tumor of uncertain malignant potential (FT-UMP) for follicular carcinomas with questionable capsular invasion; and well differentiated tumor of uncertain malignant potential (WDT-UMP) for follicular carcinomas with questionable nuclear changes. In the nineties, we did not report tall cell and columnar cell variants of papillary carcinoma, which are more aggressive than conventional papillary carcinoma (Livolsi, 2010). We report these now although very rarely.…”

Section: Endocrine Pathologymentioning

confidence: 59%

How Our Practice of Histopathology, Especially Tumour Pathology has Changed in the Last Two Decades: Reflections from a Major Referral Center in Pakistan

Ahmad

Idrees²,

Fatima³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Continued advances in the field of histo pathology (and cyto pathology) over the past two decades have resulted in dramatic changes in the manner in which these disciplines are now practiced. This is especially true in the setting of a large university hospital where the role of pathologists as clinicians (diagnosticians), undergraduate and postgraduate educators, and researchers has evolved considerably. The world around us has changed significantly during this period bringing about a considerable change in our lifestyles and the way we live. This is the world of the internet and the world-wide web, the world of Google and Wikipedia, of Youtube and Facebook where anyone can obtain any information one desires at the push of a button. The practice of histo (and cyto) pathology has also evolved in line with these changes. For those practicing this discipline in a poor, developing country these changes have been breathtaking. This is an attempt to document these changes as experienced by histo (and cyto) pathologists practicing in the biggest center for Histopathology in Pakistan, a developing country in South Asia with a large (180 million) and ever growing population. The Section of Histopathology, Department of Pathology and Microbiology at the Aga Khan University Hospital (AKUH) in Karachi, Pakistan's largest city has since its inception in the mid-1980s transformed the way histopathology is practiced in Pakistan by incorporating modern methods and rescuing histopathology in Pakistan from the primitive and outdated groove in which it was stuck for decades. It set histopathology in Pakistan firmly on the path of modernity and change which are essential for better patient management and care through accurate and complete diagnosis and more recently prognostic and predictive information as well.

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Papillary Carcinoma Tall Cell Variant (TCV): A Review

Cited by 72 publications

References 19 publications

Tall cell papillary thyroid carcinoma: new diagnostic criteria and mutations in BRAF and TERT

Tall cell papillary thyroid carcinoma: new diagnostic criteria and mutations in BRAF and TERT

Tall Cell Variant of Papillary Thyroid Carcinoma

How Our Practice of Histopathology, Especially Tumour Pathology has Changed in the Last Two Decades: Reflections from a Major Referral Center in Pakistan

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