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

20 Scopus citations

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 - 2013

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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