Papillary thyroid carcinoma

Papillary thyroid carcinoma 

Updated: 01/26/2023

© Jun Wang, MD, PhD

General features
  • Most common thyroid carcinoma
  • Usually young women
  • Risk factors
Ionizing radiation
Radioactive material
Hashimoto’s thyroiditis
  • May be Familial
  • Diagnosed cytologically (fine needle aspiration, FNA) or histologically
  • Usually excellent prognosis
  • Indicators for poor prognosis: tall cell, columnar or diffuse sclerosing variants; vascular invasion; poorly differentiated areas
Clinical features
  • Painless nodule or mass in neck or cervical node
Radiologic features
  • Usually cold on scan
Pathological features
  • Most important morphological clue: nuclear features including clear chromatin, inclusion, grooves, etc
  • Solid, white, firm, often multifocal, encapsulated or infiltrative
  • May have calcification
  • Papillae or follicles lined by follicular cells with overlapping nuclei
  • Finely dispersed optically clear chromatin (also called ground-glass, Orphan-Annie nuclei)
  • Eosinophilic intranuclear inclusions (represent cytoplasmic invaginations)
  • Nuclear longitudinal grooves
  • Further classified according to architectural pattern and/or morphology of tumor cells: follicular variant, tall cell variant, etc
  • Follicular variant
Follicular architecture
Cells with nuclear feature of papillary carcinoma
Higher frequency of RAS mutation
Less mutation of RET-PTC, BRAF
Marker
  • Positive for thyroglobulin, TTF1
  • Negative for calcitonin
Molecular abnormality
  • RET-PTC
  • BRAF
  • NTRK1
  • RAS: follicular variant
Treatment
  • Total thyroidectomy
  • Radioiodine
  • Thyrotropin suppression



Back to thyroid pathology
Back to pathology of endocrine system
Back to contents

Comments

Post a Comment

Popular posts from this blog

Contents

Pathology notes Jun Wang, MD, PhD 1. General information Frequently discussed syndromes Terms of dermatology Terms of hematology 2. Primary immunodeficiency disorders 3. Hemodynamic abnormalities Shock Thrombosis and embolism Bleeding disorders 4.  Benign blood cell disorders Anemia Benign white cell disorders 5. Hematopoietic neoplasms Lymphoid neoplasms Myeloid neoplasms Histiocytic neoplasms: Langerhans cell histiocytosis 6. Cardiovascular system Pulmonary hypertension Cardiovascular system tumors 7. Respiratory tract tumors 8. Gastrointestinal tract Congenital disorders Infectious gastroenteritis Oral cavity Esophagus Stomach Intestinal tumors Salivary glands Exocrine pancreas and gallbladder 9. Urinary system Kidney masses Lower urinary tract 10. Male reproductive system 11. Female genital tract 12. Breast 13. Endocrine organs Pituitary gland Adrenal gland Thyroid gland Parathyroid gland Endocrine pancreas...
Read more

Anemia

Anemia Updated: 07/13/2024 © Jun Wang, MD, PhD   General features Decrease in red cell mass Hemoglobin: Levels of hemoglobin in a specific volume of whole blood Hematocrit: Fraction of whole blood composed of red blood cells Red cell count: Quantity of red cell in a specific volume of whole blood Three major groups based on RBC sizes Microcytic Normocytic Macrocytic Three major causes Blood loss: acute or chronic Increased red cell destruction: hemolysis Reduced production: marrow failure due to genetic abnormality or nutritional deficiency Etiology Genetic abnormality Hemoglobinopathies RBC cytoskeletal abomorlities Enzyme abnormalities Fanconi anemia Nutritional deficiencies: iron, VB12, folate, general malnutrition Physical etiologies: trauma, burns, frostbite, prosthetic valves, etc Chronic diseases: chronic infections, neoplasia, autoimmune disorders, kidney or liver diseases, etc Infectious diseases: hepatitis, sepsis , malaria, e...
Read more

Lymphoid neoplasms

Lymphocytic neoplasms Updated: 05/17/2020 © Jun Wang, MD, PhD Terminology Lymphoma : Proliferations forming discrete tissue masses Leukemia : Widespread involvement of the bone marrow and usually the peripheral blood Any "lymphoma" can present with or evolve to a leukemic picture, and any "leukemia" can occasionally present with a mass lesion Other hematology terms Important risk factors Immunodeficiency (primary or secondary) Autoimmune disorders Viruses (HIV, KSHV/HHV8, HTLV-1) H. pylori infection Radiation Chemotherapy Diagnostic approaches Complete history, especially those with possible epidemic characters, such as Burkitt lymphoma CBC, Bone marrow Morphology/immunohistochemistry Immunofluorescence flow cytometry Cytogenetic studies Molecular studies Commonly used markers All lymphomas: CD45 B-cell neoplasms: CD5, CD10, CD19, CD20, CD79a, CD23, bcl2, bcl6, cyclin D1, light chai...
Read more