Papillary thyroid carcinoma and its variants in fine needle aspiration smears. A cytomorphologic study with special reference to tall cell variant.
OBJECTIVE
To study the fine needle aspiration (FNA) cytologic features of papillary thyroid carcinoma (PTC) with special reference to its tall cell variant (TCV), which is the most aggressive of the variants.


METHODS
Fifty-four PTC cases were classified into variants, and the frequency of well-known morphologic criteria was determined. Four parameters were quantitatively analyzed based on a study of 200 consecutive neoplastic follicular cells: shape of cells, color of cytoplasm, intranuclear cytoplasmic inclusion (INCI) and nuclear grooves.


RESULTS
The PTC cases included 6 TCV (> or = 30% tall cells), 8 cases with a significant tall cell component (sig. TCC) having 10-29% tall cells, 17 usual variant (UV), 17 follicular variant (FV) and 6 miscellaneous variants. TCV differed significantly from UV and FV in having a higher tall cell count, higher count of cells with reddish cytoplasm and INCI, and higher frequency of cases with lymphocytic infiltration. PTC (with significant tall cell component [TCC]) differed significantly from TCV with regard to tall cell count and lymphocytic infiltration, from UV with respect to tall cell count and monolayered sheets, and from FV with respect to tall cells, INCI, grooved nuclei, acinar formation, fire-flare appearance and giant cells.


CONCLUSIONS
TCV was cytologically distinct from other variants. The biologic behavior of PTC cases with significant TCC, which morphologically seem to be a group intermediate between TCV on the one hand and UV and FV on the other, however, needs to be carefully monitored.
Das
Dilip K
DK
Department of Pathology, Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait. dilip76@hotmail.com
Mallik
Mrinmay K
MK
Sharma
Prem
P
Sheikh
Zaffar A
ZA
Mathew
Pulickamattathil A
PA
Sheikh
Mehraj
M
Mirza
Kahvic
K
Madda
John P
JP
Francis
Issam M
IM
Junaid
Thamradeen A
TA
D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000473:pathology*; D002648:Child; D003581:Cytodiagnosis / Q000592:standards; D004801:Eosine Yellowish-(YS); D005260:Female; D014644:Genetic Variation; D006801:Humans; D008297:Male; D008751:Methylene Blue; D008875:Middle Aged; D012189:Retrospective Studies; D013048:Specimen Handling / Q000379:methods*; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D014626:Vaginal Smears
C043260:May-Grunwald Giemsa; D008751:Methylene Blue; D004801:Eosine Yellowish-(YS)