Preoperative Cytologic Diagnosis of Warthin-like Variant of Papillary Thyroid Carcinoma
Background Warthin-like variant of papillary thyroid carcinoma (WLV-PTC) is a relatively rare variant of papillary thyroid carcinoma with favorable prognosis. However, preoperative diagnosis using fine-needle aspiration (FNA) specimens is challenging especially with lymphocytic thyroiditis character...
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Korean Society of Pathologists & the Korean Society for Cytopathology
2018-03-01
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doaj-4187016bfc4046b3b3a48b850aec9c762020-11-24T23:54:08ZengKorean Society of Pathologists & the Korean Society for CytopathologyJournal of Pathology and Translational Medicine2383-78372383-78452018-03-0152210510910.4132/jptm.2017.12.2616753Preoperative Cytologic Diagnosis of Warthin-like Variant of Papillary Thyroid CarcinomaJisup KimBeom Jin Lim0Soon Won Hong1Ju Yeon Pyo2 Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, KoreaBackground Warthin-like variant of papillary thyroid carcinoma (WLV-PTC) is a relatively rare variant of papillary thyroid carcinoma with favorable prognosis. However, preoperative diagnosis using fine-needle aspiration (FNA) specimens is challenging especially with lymphocytic thyroiditis characterized by Hürthle cells and lymphocytic background. To determine a helpful cytological differential point, we compared WLV-PTC FNA findings with conventional papillary thyroid carcinoma with lymphocytic thyroiditis (PTC-LT) and conventional papillary thyroid carcinoma without lymphocytic thyroiditis (PTC) regarding infiltrating inflammatory cells and their distribution. Preoperative diagnosis or potential for WLV-PTC will be helpful for surgeons to decide the scope of operation. Methods Of the 8,179 patients treated for papillary thyroid carcinoma between January 2007 and December 2012, 16 patients (0.2%) were pathologically confirmed as WLV-PTC and four cases were available for cytologic review. For comparison, we randomly selected six PTC-LT cases and five PTC cases during the same period. The number of intratumoral and background lymphocytes, histiocytes, neutrophils, and the presence of giant cells were evaluated and compared using conventional smear and ThinPrep preparations. Results WLV-PTC showed extensive lymphocytic smear with incorporation of thyroid follicular tumor cell clusters and frequent histiocytes. WLV-PTC was associated with higher intratumoral and background lymphocytes and histiocytes compared with PTC-LT or PTC. The difference was more distinct in liquid-based cytology. Conclusions The lymphocytic smear pattern and the number of inflammatory cells of WLV-PTC are different from those of PTC-LT or PTC and will be helpful for the differential diagnosis of WLV-PTC in preoperative FNA.http://www.jpatholtm.org/upload/pdf/jptm-2017-12-26.pdfWarthin-like variantThyroid cancer, papillaryHashimoto diseaseBiopsy, fine-needle |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jisup Kim Beom Jin Lim Soon Won Hong Ju Yeon Pyo |
spellingShingle |
Jisup Kim Beom Jin Lim Soon Won Hong Ju Yeon Pyo Preoperative Cytologic Diagnosis of Warthin-like Variant of Papillary Thyroid Carcinoma Journal of Pathology and Translational Medicine Warthin-like variant Thyroid cancer, papillary Hashimoto disease Biopsy, fine-needle |
author_facet |
Jisup Kim Beom Jin Lim Soon Won Hong Ju Yeon Pyo |
author_sort |
Jisup Kim |
title |
Preoperative Cytologic Diagnosis of Warthin-like Variant of Papillary Thyroid Carcinoma |
title_short |
Preoperative Cytologic Diagnosis of Warthin-like Variant of Papillary Thyroid Carcinoma |
title_full |
Preoperative Cytologic Diagnosis of Warthin-like Variant of Papillary Thyroid Carcinoma |
title_fullStr |
Preoperative Cytologic Diagnosis of Warthin-like Variant of Papillary Thyroid Carcinoma |
title_full_unstemmed |
Preoperative Cytologic Diagnosis of Warthin-like Variant of Papillary Thyroid Carcinoma |
title_sort |
preoperative cytologic diagnosis of warthin-like variant of papillary thyroid carcinoma |
publisher |
Korean Society of Pathologists & the Korean Society for Cytopathology |
series |
Journal of Pathology and Translational Medicine |
issn |
2383-7837 2383-7845 |
publishDate |
2018-03-01 |
description |
Background Warthin-like variant of papillary thyroid carcinoma (WLV-PTC) is a relatively rare variant of papillary thyroid carcinoma with favorable prognosis. However, preoperative diagnosis using fine-needle aspiration (FNA) specimens is challenging especially with lymphocytic thyroiditis characterized by Hürthle cells and lymphocytic background. To determine a helpful cytological differential point, we compared WLV-PTC FNA findings with conventional papillary thyroid carcinoma with lymphocytic thyroiditis (PTC-LT) and conventional papillary thyroid carcinoma without lymphocytic thyroiditis (PTC) regarding infiltrating inflammatory cells and their distribution. Preoperative diagnosis or potential for WLV-PTC will be helpful for surgeons to decide the scope of operation. Methods Of the 8,179 patients treated for papillary thyroid carcinoma between January 2007 and December 2012, 16 patients (0.2%) were pathologically confirmed as WLV-PTC and four cases were available for cytologic review. For comparison, we randomly selected six PTC-LT cases and five PTC cases during the same period. The number of intratumoral and background lymphocytes, histiocytes, neutrophils, and the presence of giant cells were evaluated and compared using conventional smear and ThinPrep preparations. Results WLV-PTC showed extensive lymphocytic smear with incorporation of thyroid follicular tumor cell clusters and frequent histiocytes. WLV-PTC was associated with higher intratumoral and background lymphocytes and histiocytes compared with PTC-LT or PTC. The difference was more distinct in liquid-based cytology. Conclusions The lymphocytic smear pattern and the number of inflammatory cells of WLV-PTC are different from those of PTC-LT or PTC and will be helpful for the differential diagnosis of WLV-PTC in preoperative FNA. |
topic |
Warthin-like variant Thyroid cancer, papillary Hashimoto disease Biopsy, fine-needle |
url |
http://www.jpatholtm.org/upload/pdf/jptm-2017-12-26.pdf |
work_keys_str_mv |
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