Skip to main content

Advertisement

Log in

Papillary Thyroid Carcinoma Variants

  • Proceedings of the NASHNP Companion Meeting, February, 2011, San Antonio, TX
  • Published:
Head and Neck Pathology Aims and scope Submit manuscript

Abstract

Papillary thyroid carcinomas are the most common thyroid cancers and constitute more than 70% of thyroid malignancies. The most common etiologic factor is radiation, but genetic susceptibility and other factors also contribute to the development of papillary thyroid carcinoma. The most common variants include conventional, follicular variant and tall cell variant. However, many other uncommon variants have been described including oncocytic, columnar cell, diffuse sclerosing and solid forms. Immunohistochemical staining with TTF-1 and thyroglobulin is very useful in confirming the diagnosis of papillary thyroid carcinoma especially in metastatic sites. Markers such as HBME-1 and CITED1 can assist in separating some difficult cases of follicular variants of papillary thyroid carcinomas from follicular adenomas. Molecular studies have shown that the BRAF V600E mutation is found mainly in papillary and anaplastic thyroid carcinomas. Other molecular markers such as HMGA2 and insulin-like growth factor II mRNA binding protein 3 have been used recently as molecular tests to separate papillary thyroid carcinoma and its variants from follicular adenomas and other benign thyroid nodules.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Khan A, Nose V. In: Lloyd RV, editor. Endocrine pathology: differential diagnosis and molecular advances, 2nd ed. New York: Springer 2010; p. 181–236.

  2. DeLellis RA, Lloyd RV, Heitz PU, Eng C, editors. Pathology and genetics of tumours of endocrine organs. In: Kleihues P, Sobrin LH, series editors. World health organization. Classification of Tumours. Lyon: IARC Press; 2004.

  3. Hemminiki K, Li X. Familial risk of cancer by site and histopathology. Int J Cancer. 2003;103:105–9.

    Article  Google Scholar 

  4. Isaacs JD, Lundgren CI, Sidhu SB, et al. The Delphian lymph node in thyroid cancer. Ann Surg. 2008;247:477–82.

    Article  PubMed  Google Scholar 

  5. Wallander M, Layfield LJ, Jarboe E, et al. Follicular variant of papillary carcinoma: reproducibility of histologic diagnosis and utility of HBME-1 immunohistochemistry and BRAF mutational analysis as diagnostic adjuncts. Appl Immunohistochem Mol Morphol. 2010;18:231–5.

    Article  CAS  PubMed  Google Scholar 

  6. Lloyd RV, Erickson LA, Casey MB, et al. Observer variation in the diagnosis of follicular variant of papillary thyroid carcinoma. Am J Surg Pathol. 2004;28:1336–40.

    Article  PubMed  Google Scholar 

  7. Rivera M, Ricarte-Filho J, Patel S, et al. Encapsulated thyroid tumors of follicular cell origin with high grade features (high mitotic rate/tumor necrosis): a clinicopthologic and molecular study. Hum Pathol. 2010;41:172–80.

    Article  CAS  PubMed  Google Scholar 

  8. Hawk WA, Hazard JB. The many appearances of papillary carcinoma of the thyroid. Cleve Clin Q. 1976;43:207–15.

    CAS  PubMed  Google Scholar 

  9. Johnson TL, Lloyd RV, Thompson NW, et al. Prognostic implications of the tall cell variant of papillary thyroid carcinoma. Am J Surg Pathol. 1988;12:22–7.

    Article  CAS  PubMed  Google Scholar 

  10. Herrera MF, Hay ID, Wu PS, et al. Hurthle cell (oxyphilic) papillary thyroid carcinoma: a variant with more aggressive biologic behavior. World J Surg. 1992;16:669–74.

    Article  CAS  PubMed  Google Scholar 

  11. Evans HL. Columnar-cell carcinoma of the thyroid. A report of two cases of an aggressive variant of thyroid carcinoma. Am J Clin Pathol. 1986;85:77–80.

    CAS  PubMed  Google Scholar 

  12. Koo JS, Hong S, Park CS. Diffuse sclerosing variant is a major subtype of papillary thyroid carcinoma in the young. Thyroid. 2009;19:1225–31.

    Article  PubMed  Google Scholar 

  13. Asioli S, Erickson LA, Sebo TJ, et al. Papillary thyroid carcinoma with prominent hobnail features: a new aggressive variant of moderately differentiated papillary carcinoma. A clinicopathologic immunohistochemical, and molecular study of eight cases. Am J Surg Pathol. 2010;34:44–52.

    Article  PubMed  Google Scholar 

  14. Kakudo K, Tang W, Ito Y, et al. Papillary carcinoma of the thyroid in Japan: subclassification of common type and identification of low risk group. J Clin Pathol. 2004;10:1041–6.

    Article  Google Scholar 

  15. Nassar H. Carcinomas with micropapillary morphology: clinical significance and current concepts. Adv Anat Pathol. 2004;11:297–303.

    Article  PubMed  Google Scholar 

  16. Albores-Saavedra J, Hernandez M, Sanchez-Sosa S, et al. Histologic variants of papillary and follicular carcinomas associated with anaplastic spindle and giant cell carcinomas of the thyroid: an analysis of rhabdoid and thyroglobulin inclusions. Am J Surg Pathol. 2007;31:729–36.

    Article  PubMed  Google Scholar 

  17. Scognamiglio T, Hyjek E, Kao J, Chen YT. Diagnostic usefulness of HBME1, galectin-3, CK19, and CITED1 and evaluation of their expression in encapsulated lesions with questionable features of papillary thyroid carcinoma. Am J Clin Pathol. 2006;126:700–8.

    Article  CAS  PubMed  Google Scholar 

  18. Nikiforova MN, Nikiforov YE. Molecular genetics of thyroid cancer: implications for diagnosis treatment and prognosis. Expert Rev Mol Diagn. 2008;8:83–95.

    Article  CAS  PubMed  Google Scholar 

  19. Lappinga PJ, Kip NS, Jin L, et al. HMGA2 gene expression analysis performed on cytologic smears to distinguish benign from malignant thyroid nodules. Cancer Cytopathol. 2010;118:287–97.

    Article  CAS  PubMed  Google Scholar 

  20. Jin L, Seys AR, Zhang S, et al. Diagnostic utility of IMP3 expression in thyroid neoplasms: a quantitative RT-PCR study. Diagn Mol Pathol. 2010;19:63–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ricardo V. Lloyd.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lloyd, R.V., Buehler, D. & Khanafshar, E. Papillary Thyroid Carcinoma Variants. Head and Neck Pathol 5, 51–56 (2011). https://doi.org/10.1007/s12105-010-0236-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12105-010-0236-9

Keywords

Navigation