Can the tall cell variant of papillary thyroid carcinoma be distinguished from the conventional type in fine needle aspirates? a cytomorphologic study with assessment of diagnostic accuracy

Hui Guan, Christopher J. Vandenbussche, Yener S. Erozan, Dorothy L. Rosenthal, Armanda D. Tatsas, Matthew T. Olson, Rui Zheng, Manon Auger, Syed Z. Ali

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: The tall cell variant of papillary thyroid carcinoma (TCV-PTC) is an aggressive variant of PTC requiring accurate cytopathologic diagnosis for early aggressive management. Study Design: Twenty-five cases of TCV-PTC in which the tall cells comprised at least 30% of surgically resected tumor were included in the study. The direct smears from a preoperative fine needle aspiration (FNA) and available hematoxylin and eosin cell block sections were reviewed. Ten cases of TCV-PTC were randomly selected and blinded with an equal number of conventional PTC cases. Representative slides were independently reviewed by 7 cytologists. Results: In a majority of the cases, the FNA direct smears were hypercellular and displayed flat monolayer sheets of cells. Tall columnar cells with cytoplasmic tails were seen in 56% of cases. The presence of large polygonal follicular cells with abundant granular oncocytic cytoplasm and distinct cell borders was the most common feature seen in all cases. Seventeen (68%) cases displayed intranuclear pseudoinclusions in cells with abundant granular cytoplasm. A correct diagnosis of TCV-PTC was made in 30-40% of cases by 7 study participants. Conclusions: The correct recognition of TCV-PTC features in preoperative FNA is important for clinical management, and reporting these features in a cytopathology report is suggested.

Original languageEnglish (US)
Pages (from-to)534-542
Number of pages9
JournalActa cytologica
Volume57
Issue number5
DOIs
StatePublished - Jan 1 2013

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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