title: Cribriform morular variant of papillary thyroid carcinoma: clinical and cytomorphological features on fine-needle aspiration.
abstract: BACKGROUND
  Cribriform-morular variant of papillary thyroid carcinoma (CMV-PTC) is a rare tumor that may arise in patients with familial adenomatous polyposis (FAP), although sporadic instances of this tumor have been reported. When it arises in FAP, CMV-PTC may present before colonic manifestations are apparent, so proper identification and classification are essential for prompt assessment of the colonic disease status and genetic and familial counseling.
  
  
  METHODS
  Nine cases of PTC with cribriform morular cytomorphology were identified at 2 large tertiary-care hospitals; 6 were true CMV-PTC with positive β-catenin and 3 were CMV-like PTC with negative β-catenin. A review of the cytomorphology and a cytology-histology correlation were performed.
  
  
  RESULTS
  Only 1 patient presented with a known history of FAP. Patients presented with a median age of 41 years (range 19-64 years). There was a clear female predilection; 8 of 9 patients (89%) were female. All cases demonstrated the classical nuclear and architectural features of PTC. In addition, the most salient features were large tissue fragments with cribriform architecture and dense cellular morules. The elongated cellular shape of the tumor cells led to the misclassification of one tumor as a tall-cell variant of PTC on the FNA material.
  
  
  CONCLUSIONS
  CMV-PTC or CMV-like PTC demonstrate cytomorphological features that overlap with classic PTC. β-Catenin immunostaining plays an important role in making a definitive diagnosis.
authors: Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA.
authors: Thiraphon
authors: T
authors: Boonyaarunnate
authors: Matthew T
authors: MT
authors: Olson
authors: Justin A
authors: JA
authors: Bishop
authors: Grace C H
authors: GC
authors: Yang
authors: Syed Z
authors: SZ
authors: Ali
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000145:classification / Q000473:pathology*; D011125:Adenomatous Polyposis Coli / Q000473:pathology*; D000328:Adult; D015142:Baltimore; D014408:Biomarkers, Tumor / Q000032:analysis; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000737:chemistry / Q000145:classification / Q000473:pathology*; D002291:Carcinoma, Papillary; D002467:Cell Nucleus / Q000473:pathology; D048430:Cell Shape; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009519:New York City; D011237:Predictive Value of Tests; D062606:Tertiary Care Centers; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000737:chemistry / Q000145:classification / Q000473:pathology*; D055815:Young Adult; D051176:beta Catenin / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; C495270:CTNNB1 protein, human; D051176:beta Catenin