• The Korean Journal of Cytopathology
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• v.10 no.2
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• pp.179-184
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• 1999

The columnar cell variant of papillary carcinoma is a rare tumor of the thyroid, associated with aggressive behavior, early metastasis, and a rapidly fatal course. We present the fine needle aspiration cytologic(FNAC) findings of columnar ceil variant of papillary carcinoma with cytohistologic correlation. In the smears, the tumor fragments showed mainly papillary pattern and a few scattered individual cells were present around the papillary fragments. The tumor cells were columnar or cuboidal and exhibited pseudostratification of the nuclei. The nuclei were oval to elongated with finely stippled chromatin and inconspicous nucleoli. Neither nuclear grooves nor intracytoplasmic inclusion was found. The FNAC diagnosis was consistent with papillary carcinoma. Total thyroidectomy was done and the histologic finding of the mass showed a predominantly papillary and focal solid proliferation of columar cells with marked nuclear pseudostratification. The unique histopathologic features and highly aggressive nature of columnar ceil variant of papillary carcinoma require that this variant should be differeniated from common papillary carcinoma of the thyroid.

• Korean Journal of Head & Neck Oncology
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• v.20 no.2
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• pp.123-127
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• 2004

Objectives: The tall cell variant is an uncommon variant and has been known as more aggressive form of papillary thyroid carcinoma (PTC). Owing to the rarity of these thyroid cancers, their clinical behavior remains incompletely understood. To elucidate the clinicopathologic characteristics of tall cell variant, we retrospectively reviewed our surgical experience of patients with tall cell variant. Methods: Between August 1993 and July 2004, a total of 11 consecutive patients who were pathologically diagnosed with tall cell variant of papillary thyroid carcinoma were enrolled in this study. All patients underwent total (8 cases) or subtotal thyroidectomy (3 cases) with central compartment node dissections. The lateral neck dissection was added in 6 patients. After the operation, neck ultrasound and serum thyroglobulin were checked regularly during the follow-up period. Results: The mean age of the patients was 56.6years (range, 30-74years) at the time of diagnosis. 3 patients were men, and 8 were women. The mean diameter of tumor was 3.7cm(range, 1.5-6.0cm), and 6 patients had lateral neck node metastasis. Extrathyroidal extension was seen in 5 patients (45%). Loco-regional recurrence was found in 2 patients (18%), and distant metastasis in 1 patient (9%). The 5-year disease free survival rate was 68%. Conclusion: The tall cell variant of papillary thyroid carcinoma is an uncommon disease. Clinicopathologic feature and prognosis of this disease show more aggressive behaviors than ordinary papillary thyroid carcinoma. More aggressive treatment and close follow-up should be undertaken in the tall cell variant of papillary thyroid carcinoma.

• Korean Journal of Head & Neck Oncology
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• v.18 no.1
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• pp.23-29
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• 2002

Mutation of the P53 tumor suppressor gene playa major role in the development of many carcinomas, namely in the colon, breast and bladder, whereas the role played by such mutations in thyroid carcinogenesis remains controversial. Vascular endothelial growth factor (VEGF) induces proliferation of endothelial cells, stimulates angiogenesis, and increases vascular permeability. Increased VEGF expression has been associated with poor clinical outcomes in many malignancies E-cadherin, a calcium-dependent transmembrane glycoprotein, is an adhesion molecule Expression of p53, VEGF and E-cadherin was assessed immunohistochemically in 19 tall columnar variant of papillary carcinoma, 24 common papillary carcinoma and 7 follicular carcinoma. The aim of this study was to evaluate the expression of P53,VEGF and E-cadherin as a potential maker for the prognosis of thyroid carcinomas. The results are as follows: 1) There were no significance in any clinical parameters examined among tall columnar variant of papillary carcinoma, common papillary carcinoma and follicular carcinoma. 2) The expression of P53 demonstrated low in tall columnar variant of papillary carcinoma, common papillary carcinoma and follicular carcinoma, but a significantly high in regional lymph node metastasis. 3) The expression of VEGF demonstrated a significantly high in regional lymph node metastasis than those without metastasis in papillary thyroid carcinoma. 4) The expression of E-cadherin demonstrated less often among papillary carcinomas with lymph node metastasis than in those without metastasis in papillary thyroid carcinoma. In conclusion, it is suggested that VEGF and E-cadherin will be useful for the diagnosis of thyroid carcinoma and serves as a biological marker for thyroid carcinoma lymph node metastasis.

• The Korean Journal of Cytopathology
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• v.11 no.1
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• pp.47-52
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• 2000

Diffuse sclerosing papillary carcinoma(DSPC), a variant of papillary carcinoma of the thyroid, is characterized by diffuse involvement of one or both thyroid lobes, and histologic features such as prominent sclerosis, intense lymphocytic infiltrate, numerous psammoma bodies, and squamous metaplasia together with the characteristic cytoarchitectural pattern of classical papillary carcinoma. We experienced a case of fine needle aspiration cytologic(FNAC) findings of DSPC, which was confirmed by histologic examination of the thyroidectomy specimens. The patient was 26 years old female who presented with diffuse firm enlargement of the thyroid gland with enlargement of many cervical lymph nodes. FNAC smears showed numerous psammoma bodies, many lymphocytes, metaplastic squamous cells, absence of stringy colloid, and epithelial cells showing classical features of papillary carcinoma, such as nuclear grooves, intranuclear unclusions, and ground glass chromatin pattern.

• Korean Journal of Head & Neck Oncology
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• v.20 no.1
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• pp.33-36
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• 2004

Papillary carcinoma of thyroid is the most common thyroid carcinoma carrying better prognosis than the other thyroid carcinoma. Among the variants in the papillary thyroid carcinoma, the tall cell variant and diffuse sclerosing variants have more aggressive behavior than the classic papillary carcinoma. Recently, a new variant of papillary carcinoma has been reported which was named warthin-like tumor of the thyroid because of its close histologic resemblance to a tumor encountered in the salivary gland, carrying favorable prognosis. Since then, in English literature, a few cases have been reported, but in Korea have not been reported yet. We report a case of warthin-like tumor of the thyroid. A 38 year-old woman who had neck mass, was administered for thyroid surgery due to suspicious thyroid cytology. Right total thyroidectomy and left subtotal thyroidectomy with central compartment node dissection was performed. Histologic diagnosis was made as a Warthin-like tumor of the thyroid.

• The Korean Journal of Cytopathology
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• v.15 no.1
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• pp.60-64
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• 2004

The macrofollicular variant of papillary thyroid carcinoma (MVPC) is characterized by macrofollicles occupying more than half of the tumor and demonstrating nuclear features of classic papillary carcinoma. It is difficult to recognize on fine needle aspiration (FNA) cytology due to the paucity of aspirated neoplastic cell clusters, especially when the tumor is associated with extensive areas of hemorrhage. Case: A 34-year-old female presented with a well-demarcated nodule in the thyroid gland, diagnosed as a benign nodule on ultrasonography and computed tomography. FNA cytology smear revealed a few small aggregates of follicular cells with morphological features suspicious for papillary carcinoma, set in a background of hemorrhage, inflammatory cells, and hemosiderin-laden macrophages. Intraoperative frozen section revealed macrofollicular nests filled with hemorrhage and composed of follicular cells demonstrating nuclear clearing and grooves. Conclusion: MVPC is a rare but distinctive variant of papillary carcinoma, which is easily mistaken for adenomatous goiter or benign macrofollicular neoplasm on radiologic findings. The cytopathologist should alert oneself on encountering benign radiologic findings and any smear composed of scant numbers of follicular cells with nuclear features suspicious for papillary carcinoma despite the bland-looking background of hemorrhage and hemosiderin-laden macrophages, and recommend intraoperative frozen sections for a definite diagnosis.

• The Korean Journal of Cytopathology
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• v.8 no.1
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• pp.52-56
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• 1997

Oxyphilic (Hurthle) cells have abundant eosinophilic granular cytoplasms and occur in both benign and malignant neoplasms of the thyroid gland. Most published studies described mainly oxyphilic tumors of follicular type, and reports on oxyphilic papillary thyroid carcinomas are rare. The oxyphilic variant of papillary carcinoma differs from the classic papillary carcinoma in its more aggressive biological behavior. We report a case of oxyphilic papillary carcinoma exhibiting exclusively oxyphilic cells in a follicular pattern without papillary structures. The pattern of papillary carcinoma was confirmed by fine needle aspiration material and lymph nodal metastasis, both of which revealed typicaled papillary structures with characteristic nuclear features, psammoma bodies, and oxyphilic cytoplasm.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.76-80
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• 1998

Generally, the papillary carcinoma generally has a favorable prognosis, and several variants of pathologic heterogeneity are recognized. Variants that are regarded as more aggressive are tall cell, columnar cell, and diffuse sclerosing types. Seventeen cases of papillary thyroid carcinoma showing clinically aggressive behavior, invading extrathyroidal structures, were retrospectively reviewed to evaluate the morphological variants of the tumors. Six of them were found to be pure papillary and nine were mixed types regarded as non-aggressive variants. Four cases were found to be tall cell variants, two cases of non-extrathryoidal invasion and two of extrathyroidal invasion regarded as aggressive variants. Our findings suggest that the prognosis of papillary carcinoma not always be based on its morphological variant and more attention should be given to other clinical parameters.

• The Korean Journal of Cytopathology
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• v.8 no.2
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• pp.150-154
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• 1997

Lymphoid infiltration can be seen in some lesions such as Hashimoto's thyroiditis, subacute thyroiditis and several neoplasm of the thyroid. In case of malignancy, there are a few reports of lymphoid infiltration in the diffuse sclerosing variant of papillary carcinoma. But heavy lymphoid infiltraton without evidence of sclerosis is uncommon. We experienced a case of papillary oxyphilic carcinoma with massive lymphoid infiltration, which looks like Warihin tumor of salivary gland. However cytological feature of epithelial cells exhibit that of papillary carcinoma.

• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.103-108
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• 2014

Thyroglossal duct cyst (TGDC) carcinoma generally shows a favorable prognosis. If metastasis is present latently, it may not threaten the patient's life immediately. It has been shown, however, that larger than 1 cm papillary carcinoma (PC), level VI metastasis to the lymph node (LN), which is the nearest to the thyroid, independently predicts a worse prognosis. In the case presented herein, a 61-year-old female patient was diagnosed with an about 3 cm PC in the TGDC, particularly the columnar variant subtype, one of the aggressive variants. She had occult papillary thyroid microcarcinoma, but no LN metastasis. Even though she underwent the Sistrunk procedure and total thyroidectomy with central compartment neck dissection followed by high-dose radioactive iodine remnant ablation, however, the cancer cells spread to level IV neck LN, and finally to the lung. Therefore, when a patient is diagnosed with an aggressive histologic variant of PC in the TGDC, even without LN metastasis, the invasive surgical approach and close postoperative surveillance are necessary, with consideration of the risk of disease progression. Therefore, if it is possible to stratify the risk for patients, higher-risk patients can be offered a more invasive therapeutic approach.