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Original Article
- Contribution of cytologic examination to diagnosis of poorly differentiated thyroid carcinoma
- Na Rae Kim, Jae Yeon Seok, Yoo Seung Chung, Joon Hyop Lee, Dong Hae Chung
- J Pathol Transl Med. 2020;54(2):171-178. Published online February 5, 2020
- DOI: https://doi.org/10.4132/jptm.2019.12.03
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- 3 Web of Science
- 5 Crossref
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Abstract
PDF - Background
The cytologic diagnosis of poorly differentiated thyroid carcinoma (PDTC) is difficult because it lacks salient cytologic findings and shares cytologic features with more commonly encountered neoplasms. Due to diverse cytologic findings and paucicellularity of PDTC, standardization of cytologic diagnostic criteria is limited. The purpose of this study is to investigate and recognize diverse thyroid findings of fine needle aspiration (FNA) cytology and frozen smear cytology in diagnosis of this rare but aggressive carcinoma.
Methods
The present study included six cases of FNA cytology and frozen smears of histologically diagnosed PDTCs.
Results
PDTC showed cytologic overlap with well-differentiated thyroid carcinomas (WDTCs). Five of six cases showed dedifferentiation arising from well differentiated thyroid carcinomas. Only one de novo PDTC showed highly cellular smears composed of discohesive small cells, high nuclear/cytoplasmic (N/C) ratio, prominent micronucleoli, and irregular nuclei. Retrospectively reviewed, these findings are highly suspicious for PDTC. Cytologic findings of nuclear atypia, pleomorphism, and irregularity were frequently found, whereas scattered small cells were seen only in the de novo case.
Conclusions
Heterogeneous cytologic findings of PDTCs are shared with those of WDTCs and contribute to difficult preoperative cytologic diagnoses. Most PDTCs show dedifferentiation from WDTCs. Albeit rare, de novo PDTC should be considered with cytology showing discohesive small cells with high N/C ratio. This will enable precise diagnosis and prompt treatment of this aggressive malignancy -
Citations
Citations to this article as recorded by
- Non-papillary thyroid carcinoma diagnoses in The Bethesda System for Reporting Thyroid Cytopathology categories V and VI: An institutional experience
Myunghee Kang, Na Rae Kim, Jae Yeon Seok
Annals of Diagnostic Pathology.2024; 71: 152263. CrossRef - Cytologic features of differentiated high‐grade thyroid carcinoma: A multi‐institutional study of 40 cases
Vanda F. Torous, Tikamporn Jitpasutham, Zubair Baloch, Richard L. Cantley, Darcy A. Kerr, Xiaoying Liu, Zahra Maleki, Ross Merkin, Vania Nosé, Liron Pantanowitz, Isabella Tondi Resta, Esther D. Rossi, William C. Faquin
Cancer Cytopathology.2024; 132(8): 525. CrossRef - An Unexpected Finding of Poorly Differentiated Thyroid Carcinoma in a Toxic Thyroid Nodule
Kimberly Yuang, Huda Al-Bahadili, Alan Chang
JCEM Case Reports.2023;[Epub] CrossRef - Revisiting the cytomorphological features of poorly differentiated thyroid carcinoma: a comparative analysis with indeterminate thyroid fine-needle aspiration samples
Yazeed Alwelaie, Ali Howaidi, Mohammed Tashkandi, Ahmad Almotairi, Hisham Saied, Moammar Muzzaffar, Doaa Alghamdi
Journal of the American Society of Cytopathology.2023; 12(5): 331. CrossRef - Characterization of the genomic alterations in poorly differentiated thyroid cancer
Yeeun Lee, SeongRyeol Moon, Jae Yeon Seok, Joon-Hyop Lee, Seungyoon Nam, Yoo Seung Chung
Scientific Reports.2023;[Epub] CrossRef
- Non-papillary thyroid carcinoma diagnoses in The Bethesda System for Reporting Thyroid Cytopathology categories V and VI: An institutional experience
Case Reports
- Sertoli-Leydig Cell Tumor of Hemangiopericytoma Pattern: A case report.
- Hye Jin Lee, Young im Han, Hyeon Ok Kim, Kang Suek Suh, Sun Kyung Lee
- Korean J Pathol. 1995;29(6):815-818.
- 1,728 View
- 14 Download
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Abstract
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- The Sertoli-Leydig cell tumor is a gonadal tumor of sex-cord stromal type, similar to that seen in of the various phases of testicular development in the male. This tumor is exceedingly rare, accounting for only 0.1% to 0.5% of all primary ovarian neoplasms. It occurs predominantly in the second and third decades(mean age about 25 years), less than 10% after menopause. We investigated a case of poorly differentiated Sertoli-Leydig cell tumor of right ovary, occured in a 76-year-old woman. Grossly, the tumor measured 2, 100 gm in weight and 25 x 19 x 8 cm in dimensions. The outer surface was smooth and glistening without rupture of the capsule. Cut sections revealed a multilobulated brown solid mass with multiple cystic change. Microscopically, it showed the typical findings o a Sertoli-Leydig cell tumor. The characteristic feature is hemangiopericytoma paftem of sarcomatoid spindle cells. Therefore, we present it with a brief review of the literature.
- Aspiration Cytology of Insular Carcinoma of Thyroid: A Case Report.
- Young Il Yang, Chan Hawn Kim, Shin Kwang Khang
- Korean J Cytopathol. 1994;5(1):46-51.
- 1,605 View
- 12 Download
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Abstract
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- Fine needle aspiration cytologic features of a case of insular carcinoma of the thyroid in a 23-year-old woman who presented a palpable neck mass is described. The aspirate showed cellular smear arranged in trabeculae, solid or loose clusters, and microfollicles in necrotic background. The tumor cells had uniform, small round, hyperchromatic nuclei. The chromatin was finely granular, and nuclear membrane was smooth. Nucleoli were not discernible. Nuclear pleomorphism was minimal. The cytoplasm was usually scanty, pale, poorly outlined, and almostly amphophilic. Sometimes paranuclear cytoplasmic vacuoles were noted. Final diagnosis was confirmed by total thyroidectomy as insular carcinoma.
- Fine Needle Aspiration Cytoloy of Poorly Differentiated "Insular" Carcinoma of the Thyroid: A Case Report.
- Hee Jung Lee, Kyung Shin Park, Young Shin Kim, Kyo Young Lee, Chang Suck Kang, Sang In Shim
- Korean J Cytopathol. 1998;9(1):117-122.
- 1,569 View
- 11 Download
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Abstract
PDF
- Cytologic features of a poorly differentiated "insular" carcinoma of the thyroid are presented. In fine needle aspiration cytology, the aspirates were highly cellular and tumor cells were arranged in loose clusters or singly dispersed on focally necrotic background. Occasional microfollicles were evident. The tumor cells had poorly defined, scanty cytoplasm and most of the nuclei were fairly uniform with coarse chromatin pattern. A few large pleomorphic cells were also noted. The cytologic findings of the present case were correlated well with the histologic findings, which showed typical insular pattern and the presence of uniform cells with occasional pleomorphism.
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