Cameselle-Teijeiro J, Febles-Pérez C, Cameselle-Teijeiro J F, Alfonsín-Barreiro N, Moldes-Boullosa J, Barreiro F
Department of Pathology, Hospital Xeral de Galicia, Santiago, Spain.
Acta Cytol. 1997 Jul-Aug;41(4 Suppl):1310-6. doi: 10.1159/000333526.
In contrast to typical papillary carcinoma, the tall cell variant (TCV) of thyroid papillary carcinoma has more aggressive biologic behavior. Attempts to make a specific diagnosis of TCV of papillary carcinoma based on fine needle aspiration cytology (FNAC) have been unsatisfactory.
The cytologic and histologic study of one such case was made with an emphasis given to identifying the main histologic criteria for the specific diagnosis of TCV of papillary carcinoma in FNAC smears. "Tall cells" were defined as cells with abundant eosinophilic, elongated cytoplasm; the height of these cells was twice their width or more, and they have to constitute > 30% of the tumor cell population. Tall cells were not found in smears of 20 cases of nonaggressive papillary carcinomas investigated as control cases. Only one mitotic figure was found in one slide of one of the control cases (5%) in comparison to two and three mitotic figures found in the two slides of TCV of papillary carcinoma.
In addition to conventional cytologic features of typical papillary carcinoma, the identification of both tall cells and mitotic figures in the same smears is highly indicative of TCV of papillary carcinoma. More studies will be necessary to confirm the usefulness of this clue.
与典型乳头状癌相比，甲状腺乳头状癌的高细胞变异型（TCV）具有更具侵袭性的生物学行为。基于细针穿刺细胞学检查（FNAC）对乳头状癌的TCV进行特异性诊断的尝试并不令人满意。
对其中一例进行了细胞学和组织学研究，重点是确定FNAC涂片上乳头状癌的TCV特异性诊断的主要组织学标准。“高细胞”定义为具有丰富嗜酸性、细长细胞质的细胞；这些细胞的高度是其宽度的两倍或更多，并且它们必须占肿瘤细胞群体的>30%。在作为对照病例研究的20例非侵袭性乳头状癌涂片中未发现高细胞。与乳头状癌的TCV的两张载玻片中发现的两个和三个有丝分裂象相比，在一个对照病例的一张载玻片中仅发现一个有丝分裂象（5%）。
除了典型乳头状癌的传统细胞学特征外，在同一涂片中同时识别高细胞和有丝分裂象高度提示乳头状癌的TCV。需要更多研究来证实这一线索的有用性。
