Age of patients with papillary thyroid carcinoma: is it a key factor in the development of variants?
BACKGROUND
Although the majority of papillary thyroid carcinomas (PTC) have an excellent prognosis, certain aggressive variants do occur. The tall cell variant (TCV) of PTC, which tends to occur in elderly patients, is the most common among the aggressive variants and the most aggressive of all variants.


OBJECTIVE
To compare the age of patients with major variants of PTC and correlate age with certain cytomorphological features of diagnostic importance.


METHODS
53 PTC cases with available information on age and diagnosed by fine needle aspiration cytology were categorized into various variants following a review of smears. There were 6 TCV (>or=30% tall cells) cases, 8 cases with a significant tall cell component (sig. TCC; 10-29% tall cells), 16 usual variants (UV), 17 follicular variants (FV), and 6 miscellaneous variants. These groups were compared with respect to age (mean+/-SD, median). Further, the age of all patients with PTC was correlated with cytological features such as tall cell count and count of cells with reddish cytoplasm, intranuclear cytoplasmic inclusion, and nuclear grooves.


RESULTS
The median age of patients with TCV, PTC with a sig. TCC, UV, FV and miscellaneous variants was 47.5, 44.5, 31.5, 34.0 and 42.0 years, respectively. The age of PTC (TCV) cases (52.0+/-17.84 years) and of those with a sig. TCC (45.9+/-12.12 years) was significantly higher than the age of PTC (FV) cases (34.2+/-8.21 years) (p=0.004 and 0.027, respectively). The combined age of PTC (TCV) and PTC (sig. TCC) cases (48.5+/-14.54 years) was significantly higher than the age of PTC (UV) cases (p=0.038) as well as of PTC (FV) cases (p=0.005). Six (42.9%) of the patients with PTC (TCV and sig. TCC) were >or=50 years of age as opposed to 3 (9.1%) of PTC (UV and FV) cases (p=0.0134). The age of patients with PTC in general showed a significant correlation with tall cell count (p<0.01).


CONCLUSIONS
The age of the patients with PTC seems to play a role in the morphological manifestations of the neoplasm, which is related to the prognostic outcome.
Das
Dilip Kumar
DK
Department of Pathology, Faculty of Medicine, Kuwait University, Safat, Kuwait. dilip76@hotmail.com
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D044963:Biopsy, Fine-Needle; D002291:Carcinoma, Papillary / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013961:Thyroid Gland / Q000473:pathology; D013964:Thyroid Neoplasms / Q000473:pathology*