Baum Jordan E, Soong Lauren, Scognamiglio Theresa, Margolskee Elizabeth M, Hoda Rana S, Rao Rema
Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, 525 East 68th Street, New York, New York.
Division of Cytopathology, CBLPath, 760 Westchester Avenue, Rye Brook, New York.
Diagn Cytopathol. 2019 Jun;47(6):541-546. doi: 10.1002/dc.24146. Epub 2019 Jan 16.
The tall cell variant of papillary thyroid carcinoma (PTC-TC) has been associated with aggressive features including extrathyroidal extension, higher rate of lymph node and distant metastases, and higher recurrence rate. We aimed to evaluate the cytomorphologic features of PTC-TC on ThinPrep (TP) along with its diagnostic efficacy to detect PTC-TC.
Preoperative cytology samples from 30 cases of histologically-proven PTC-TC and 30 classical PTC controls were selected for this study. TP preparations were evaluated for varying architectural and cytomorphologic features.
Tall cells were present in the majority of PTC-TC cases and were located at the periphery of cell clusters and as single cells. Cytoplasmic cuff along the periphery of cell clusters and soap-bubble pseudoinclusions were very specific features of PTC-TC, when present. PTC-TC cases were more likely to show abundant oncocytic cytoplasm and distinct cell borders. Cytoplasmic tails were more likely to be present and more numerous in PTC-TC. The presence of nuclear grooves, papillary architecture, and giant cells were not reliable distinguishing features of PTC-TC vs controls.
Our results indicate that tall cell cytomorphologic and architectural features in PTC are identifiable on TP.
甲状腺乳头状癌高细胞变体（PTC-TC）与侵袭性特征相关，包括甲状腺外侵犯、更高的淋巴结转移和远处转移率以及更高的复发率。我们旨在评估液基薄层制片（TP）上PTC-TC的细胞形态学特征及其检测PTC-TC的诊断效能。
本研究选取30例经组织学证实的PTC-TC病例和30例经典PTC对照的术前细胞学样本。对TP制片的不同结构和细胞形态学特征进行评估。
大多数PTC-TC病例中存在高细胞，其位于细胞团周边及单个存在。细胞团周边的胞质袖套和肥皂泡样假包涵体是PTC-TC的非常特异性特征（若存在时）。PTC-TC病例更易表现为丰富的嗜酸性胞质和清晰的细胞边界。PTC-TC中更易出现且数量更多的是胞质尾。核沟、乳头结构和巨细胞的存在并非PTC-TC与对照的可靠鉴别特征。
我们的结果表明，PTC中的高细胞形态学和结构特征在TP上是可识别的。
