Tumour areas were first annotated, and then, samples were scored separately by J.A. I have read and accept the terms and conditions, View permissions information for this article. New to the fourth edition of the WHO Classification of Tumours of Endocrine Organs, the hobnail variant of papillary thyroid carcinoma is a moderately differentiated papillary thyroid carcinoma variant with aggressive clinical behavior and significant mortality. A kappa value was calculated for the two scorers of TC composition. Another strength is our approach of scanning and digitally analysing the slides, making it possible to scan tumours more systematically for TCs. Lloyd, RV, Osamura, RY, Kloppel, G. WHO classification of tumours: pathology and genetics of tumours of endocrine organs. Author information: (1)Department of Pathology and Laboratory Medicine, College of Medicine-Jacksonville, University of Florida, Jacksonville, FL 32209, USA. Aims. The scanner used was a Panoramic p250 flash III manufactured by 3DHISTECH equipped with a 20× objective (NA 0.8). Another means to tackle this problem is by developing non-subjective artificial intelligence software to evaluate TC composition. The diagnosing of TCV is of clinical importance since according to current guidelines, patients with TCV should be treated more aggressively than those with conventional PTC variant. Due to the exceptionally good prognosis of PTC compared to that of most other cancers, identification of an appropriate number of patients with adverse outcome requires a very large cohort. In multivariate analysis, a 70% cut-off and age at diagnosis significantly affected DSS. Thus, the cohort reflects the normal patient population of our hospital, and the impact of the TCs was not underestimated. Hi, I'm also looking for someone who is dealing with the diagnosis of tall cell variant papillary thyroid cancer. This tumor must be distinguished from poorly differentiated thyroid carcinoma which has the same growth pattern but lacks nuclear features of papillary thyroid carcinoma and may show tumor necrosis and high mitotic activity. Find out about Lean Library here, If you have access to journal via a society or associations, read the instructions below. Primary neoplasms arising from such thyroid nests are rare. Introduction. Cases for whom investigators disagreed, after discussion, received a consensus score. Tall cell variant of papillary carcinoma arising from a thyroglossal cyst: report of a case with diagnosis by fine needle aspiration cytology. The aggressive behavior has been ascribed to the histologic subtype and/ or to the clinicopathologic features, an issue that remains controversial. Tall-cell variant of papillary thyroid cancer: disregarded entity? Although its pathological diagnosis may be challenging, its prognosis is generally favorable. New to the fourth edition of the WHO Classification of Tumours of Endocrine Organs, the hobnail variant of papillary thyroid carcinoma is a moderately differentiated papillary thyroid carcinoma variant with aggressive clinical behavior and significant mortality. In a … ORCID iDSebastian Stenman https://orcid.org/0000-0001-5780-0285. The columnar variant of papillary thyroid carcinoma can be aggressive, particularly in older patients, with larger tumors showing a diffusely infiltrative growth pattern and extrathyroidal extension. 24, 25, 47 The tumors show an extensive papillary … However, tumor cells growing in the ‘tram-track’ pattern should trigger a careful search for tall cells (HE, 200×). The tall cell variant of papillary thyroid carcinoma is the most common aggressive variant of papillary thyroid carcinoma. In some series it has accounted for up to 10%, whereas in other series it has not been reported at all, indicating that there are difficulties identifying it. This study complies with the Declaration of Helsinki and was approved by the Surgical Ethics Committee of Helsinki University Hospital (DNo. All had originally been diagnosed with PTC and had undergone initial surgery at the Department of Surgery, Helsinki University Hospital, between 1 January 1973 and 31 December 1996.4 Adverse outcome was based on need for more than three iodine ablations or surgery for recurrent disease occurring more than once within 6 months after the primary operation, or distant metastases 6 months after that operation, or primary distant metastases or death from PTC (Table 1).4. The adverse outcome group of 34 and the control group of 31 were analysed and scored based on their TC composition. If you have access to a journal via a society or association membership, please browse to your society journal, select an article to view, and follow the instructions in this box. Kaplan–Meier survival analysis, including all cases, showed only the 70% cut-off to be associated with reduction in OS (p = 0.005, hazard ratio (HR) = 2.93), DSS (p = 0.004, HR = 4.74) and RFS (p = 0.029, HR = 2.28; Figures 2 and 3). A retrospective study of three such cases was made, with an emphasis given to the utility of fine needle aspiration cytology in their identification. Papillary thyroid cancer or papillary thyroid carcinoma is the most common type of thyroid cancer, representing 75 percent to 85 percent of all thyroid cancer cases. Papillary thyroid carcinoma (PTC) is the most common malignant endocrine tumor. The aggressive behavior has been ascribed to the histologic subtype and/ or to the clinicopathologic features, an issue that remains controversial. Median age at diagnosis was 46 (standard deviation (SD) = 20.3) years, with median age at diagnosis of the adverse outcome group was 42 (SD = 21) years and of the control group 50 (SD = 19) years. Those … The e-mail addresses that you supply to use this service will not be used for any other purpose without your consent. A papillary thyroid carcinoma is designated as solid/ trabecular variant when all or nearly all of a tumor not belonging to any of the other variants has a solid, trabecular, or nested (insular) appearance. A papillary thyroid carcinoma is designated as solid/ trabecular variant when all or nearly all of a tumor not belonging to any of the other variants has a solid, trabecular, or nested (insular) appearance. Papillary thyroid carcinoma (PTC) is considered a well differentiated neoplasm and is the most common thyroid gland malignancy accounting for 75–85% of all thyroid carcinomas [].Several morphologic variants of PTC have been described which account for up to 25% of all cases [].Some of these variants including tall cell, diffuse sclerosing, and columnar cell variants … Aggressive Variants of Papillary Thyroid Carcinoma : Hobnail, Tall Cell, Columnar, and Solid. A tall cell composition of 10%, 30% or 50% showed no correlation with adverse outcome and suggests that the choice of pathologists reporting tall-cell variant should be a 70% threshold. The columnar variant of papillary thyroid carcinoma can be aggressive, particularly in older patients, with larger tumors showing a diffusely infiltrative growth pattern and extrathyroidal extension. Changing the term "breast tumor resembling the tall cell variant of papillary thyroid carcinoma" to "tall cell variant of papillary breast carcinoma". This, in turn, allows surgeons and endocrinologists to formulate a more complete treatment plan, including total thyroidectomy, possible lymphadenectomy, and postoperative radioiodine administration. Tumor cells have abundant eosinophilic cytoplasm, necrosis, mitotic activity and nuclear features similar to conventional papillary carcinoma. BACKGROUND: Recent studies have shown a correlation between lymphocytic thyroiditis and papillary carcinoma of the thyroid… A rare entity termed "breast tumor resembling the tall cell variant of papillary thyroid carcinoma" is considered to be a subtype of papillary carcinoma of the breast. The aggressive behavior has been ascribed to the histologic subtype and/ or to the clinicopathologic features, an issue that remains controversial. Applying this clear definition in practice is, however, challenging, since measuring every cell in a tumour under a traditional microscope is unrealistic. Aggressive Variants of Papillary Thyroid Carcinoma: Hobnail, Tall Cell, Columnar, and Solid. The tumor is multicentric in 20 to 80% of cases, depending on the care used to examine the thyroid, and is bilateral in approximately one-third … Regardless of the cut-off for tall cell proportion in PTCs, reproducibility in validation series is essential. … Within the last few years, the diagnostic criteria for this entity have evolved. The tall cell variant of papillary thyroid carcinoma is the most common aggressive variant of papillary thyroid carcinoma. Integrated genomic characterization of papillary thyroid carcinoma. Ectopic thyroid tissue within the submucosa of the trachea is a rare cause of upper airway obstruction. Papillary thyroid carcinomas measuring less than or equal to 1.0 cm are classified as … Thyroid carcinoma shows an increasing incidence globally and is about two to four times as common in women.1–3 Papillary thyroid carcinoma (PTC) has the most favourable outcome of all thyroid carcinoma subtypes, especially among young patients; one of the most important prognostic factors is age at diagnosis.4–6 Microscopically, the nuclei of PTC are characterized by highly irregular nuclear contours and prominent longitudinal grooves or nuclear pseudoinclusions.7, PTC has several histological sub-variants. Pisani T(1), Giovagnoli MR, Intrieri FS, Vecchione A. The new World Health Organization 2017 classification defines a tall-cell variant as a tumour consisting of over 30% of cells that are two or three times as tall as they are wide. The right tumour is 1 cm and extrathyroid extension is present. Because there are serious prognostic and management implications to a diagnosis of TCV, we review the entity to inform clinicians about the many facets of TCV. The new World Health Organization 2017 classification defines a tall-cell variant as a tumour consisting of over 30% of cells that are two or three times as tall as they are wide. Interpretation of TC composition is subjective, with the percentage of TCs varying widely among investigators. A p value of <0.05 was considered statistically significant, and a two-tailed test was used. Tall cells should represent 50% or more of the papillary carcinoma cells to make the diagnosis of tall cell variant. Abstract Background: The tall cell variant of papillary thyroid carcinoma is an aggressive subtype that generally presents as a large tumor in the advanced stage; however, little is known about the tall cell variant of microcarcinoma (tumors measuring <1 cm). Among these tumors, certain histological variants, such as the diffuse sclerosing and tall cell carcinoma, are characterized by a more aggressive behavior. N0 – No cancer cells were found in any of the lymph nodes examined. The box illustrates the area of the next image, with (a) 2× zoom, (b) 10× zoom, (c) 20× zoom and (d) 40× zoom. Gender was not associated with higher TC composition when analysed by 10%, 30%, 50% and 70% cut-offs (p = 1.00, p = 0.777, p = 1.00 and p = 0.485, respectively; Supplementary Table). Nishant Agrawal, Rehan Akbani, B. Arman Aksoy, et al. The recommended cut-off percentage for TCV is still debated, and it is evident that it causes a confusion among pathologists when diagnosing TCV, in a review by Baloch and LiVolsi.24 Two recent studies have indicated that even a low TC score of 10% correlates with adverse outcome and suggested that this cut-off should be the choice of pathologists for defining TCVs.9,10 A newer report has, however, concluded that low TC proportion shows no correlation with poor outcome.25 Our cases with less than 10% TCs were distributed evenly between groups, with no prognostic significance observable for a low TC proportion. Differential Clinicopathological Risk and Prognosis of Major Papillary Thyroid Cancer Variants. Members of _ can log in with their society credentials below, Sebastian Stenman, Päivi Siironen, Harri Mustonen, Johan Lundin, Caj Haglund, and Johanna Arola, This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (. Table 5. It is also evident that TCV correlates with extra-thyroidal extension,11,13,14 which is also confirmed by our calculations. New to the fourth edition of the WHO Classification of Tumours of Endocrine Organs, the hobnail variant of papillary thyroid carcinoma is a moderately differentiated papillary thyroid carcinoma variant with aggressive clinical behavior and significant mortality. The most common thyroid cancer is papillary thyroid carcinoma (PTC), which represents up to 80% of all thyroid cancers. Background: The tall cell variant of papillary thyroid carcinoma is an aggressive subtype that generally presents as a large tumor in the advanced stage; however, little is known about the tall cell variant of microcarcinoma (tumors measuring <1 cm). A breast tumour resembling the tall cell variant of a papillary thyroid carcinoma (BTPTC) was first reported in 2003 by Eusebi and colleagues.1 It was described as a breast carcinoma with histological features similar to the tall cell variant of a papillary thyroid carcinoma. … Tall cell studies are something that have evolved a bit. Together they form a unique fingerprint. Kaplan–Meier survival analysis for (a) overall survival and (b) disease-specific survival for 70% tall-cell (TC) threshold in papillary thyroid carcinoma. Seven of these patients were in the group with an aggressive tumour, and six in the recovered group. Knowing the variants of papillary carcinoma thyroid can help in predicting the aggressive biological course and prognosis of the disease. T4 stage showed a correlation with an increasing TC score (p = 0.002). The literature on this tumor is reviewed. Lean Library can solve it. Please check you selected the correct society from the list and entered the user name and password you use to log in to your society website. Prognostic significance of the proportion of tall cell components in papillary thyroid carcinoma, A study of recurrence and death from papillary thyroid cancer with 27 years of median follow-up, IEEE Journal of Biomedical and Health Informatics, Current Opinion in Endocrinology, Diabetes & Obesity, SAGE Publications Ltd, or International Society of Oncology and BioMarkers (ISOBM), unless otherwise noted. 1 Although its global incidence has been increasing over the last decades, when its most common variants (ie, classic and follicular) are considered, the prognosis is very good and the mortality rate remains very … Conclusions: Warthin-like tumors can be mistaken for benign lymphoepithelial lesions of the thyroid, Hürthle cell carcinoma, and tall cell variant of papillary carcinoma in both fine-needle aspiration and histology specimens. The columnar variant of papillary thyroid carcinoma can be aggressive, particularly in older patients, with larger tumors showing a diffusely infiltrative growth pattern and extrathyroidal extension. / Nath, Meryl C.; Erickson, Lori A. T1 - Aggressive Variants of Papillary Thyroid Carcinoma, T2 - Hobnail, Tall Cell, Columnar, and Solid. Post-Sx iodine scan. PTC can demonstrate a number of morphologic variants including but not limited to classic, follicular, and tall cell. This site uses cookies. (a) Tall cell variant papillary thyroid carcinoma with a trabecular growth pattern. At present, it is limited to case reports. It occurs more frequently in women and presents in the 20–55 year age group. During follow-up, metastasis occurred in 15 patients, and 12 died of PTC, one at 4 months. Tall cell variant—at least 30% of the neoplasm with tall cells (height-to-width ratio >2), basally oriented nuclei showing the classic nuclear features of papillary carcinoma (grooves, ground glass chromatin, intranuclear inclusions), abundant eosinophilic cytoplasm, and numerous papillae (Fig.

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