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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = Papillary_thyroid_microcarcinoma_-_high_mag.jpg | | Image = Papillary_thyroid_microcarcinoma_-_high_mag.jpg | ||
| Width = | | Width = | ||
| Caption = Papillary thyroid carcinoma. [[H&E stain]]. | | Caption = Papillary thyroid carcinoma. [[H&E stain]]. | ||
| Micro = nuclear changes: nuclear membrane irregularities (e.g. raisinoid shape), +/-nuclear grooves, +/-[[nuclear pseudoinclusions]], +/-nuclear clearing, nuclear enlargement (usu. mild), nucleoli; architectural changes: overlap of nuclei, papillae (not required), +/-[[psammoma bodies]] | | Micro = nuclear changes: nuclear membrane irregularities (e.g. raisinoid shape), +/-nuclear grooves, +/-[[nuclear pseudoinclusions]], +/-nuclear clearing, nuclear enlargement (usu. mild), nucleoli; architectural changes: overlap of nuclei, papillae (not required), +/-[[psammoma bodies]] | ||
| Subtypes = [[Papillary thyroid carcinoma tall cell variant|tall cell variant]], [[Papillary thyroid carcinoma columnar cell variant|columnar cell variant]], [[Papillary thyroid carcinoma follicular variant|follicular variant]], [[Papillary thyroid carcinoma cribriform-morular variant|cribriform-morular variant]], [[Papillary thyroid carcinoma diffuse sclerosing variant|diffuse sclerosing variant]], [[Papillary thyroid carcinoma Warthin-like variant|Warthin-like variant]], [[Papillary thyroid carcinoma solid variant|solid variant]], [[Papillary thyroid carcinoma oncocytic variant|oncocytic variant]], others | | Subtypes = [[Papillary thyroid carcinoma tall cell variant|tall cell variant]], [[Papillary thyroid carcinoma columnar cell variant|columnar cell variant]], [[Papillary thyroid carcinoma follicular variant|follicular variant]], [[Papillary thyroid carcinoma cribriform-morular variant|cribriform-morular variant]], [[Papillary thyroid carcinoma diffuse sclerosing variant|diffuse sclerosing variant]], [[Papillary thyroid carcinoma Warthin-like variant|Warthin-like variant]], [[Papillary thyroid carcinoma solid variant|solid variant]], [[Papillary thyroid carcinoma oncocytic variant|oncocytic variant]], others | ||
| LMDDx = [[lymphocytic thyroiditis]] ([[Graves disease]], [[Hashimoto thyroiditis]]), [[solid cell nest of thyroid]], [[follicular thyroid carcinoma]], [[follicular thyroid adenoma]], [[adenomatoid nodule]] | | LMDDx = [[lymphocytic thyroiditis]] ([[Graves disease]], [[Hashimoto thyroiditis]]), [[solid cell nest of thyroid]], [[follicular thyroid carcinoma]], [[follicular thyroid adenoma]], [[adenomatoid nodule]], [[noninvasive follicular thyroid neoplasm with papillary-like nuclear features]] (NIFTP) | ||
| Stains = | | Stains = | ||
| IHC = HBME-1 +ve, | | IHC = HBME-1 +ve, [[CK19]] +ve, Galectin-3 +ve, thyroglobulin +ve, TTF-1 +ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
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| Gross = | | Gross = | ||
| Grossing = | | Grossing = | ||
| Staging = [[thyroid cancer staging]] | |||
| Site = [[thyroid gland]] | | Site = [[thyroid gland]] | ||
| Assdx = | | Assdx = | ||
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DDx: | DDx: | ||
*[[Noninvasive follicular thyroid neoplasm with papillary-like nuclear features]] (NIFTP). | |||
*[[Follicular thyroid carcinoma]] - has a fibrous capsule and invasion though it. | *[[Follicular thyroid carcinoma]] - has a fibrous capsule and invasion though it. | ||
*[[Follicular thyroid adenoma]] - surrounded by a fibrous capsule. | *[[Follicular thyroid adenoma]] - surrounded by a fibrous capsule. | ||
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Images: | Images: | ||
===Papillary thyroid carcinoma cribriform-morular variant=== | |||
=====General===== | =====General===== | ||
*Associated with [[familial adenomatous polyposis]] (FAP).<ref name=pmid18612695>{{cite journal |author=Groen EJ, Roos A, Muntinghe FL, ''et al.'' |title=Extra-intestinal manifestations of familial adenomatous polyposis |journal=Ann. Surg. Oncol. |volume=15 |issue=9 |pages=2439–50 |year=2008 |month=September |pmid=18612695 |pmc=2518080 |doi=10.1245/s10434-008-9981-3 |url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518080/?tool=pubmed}}</ref> | *Associated with [[familial adenomatous polyposis]] (FAP).<ref name=pmid18612695>{{cite journal |author=Groen EJ, Roos A, Muntinghe FL, ''et al.'' |title=Extra-intestinal manifestations of familial adenomatous polyposis |journal=Ann. Surg. Oncol. |volume=15 |issue=9 |pages=2439–50 |year=2008 |month=September |pmid=18612695 |pmc=2518080 |doi=10.1245/s10434-008-9981-3 |url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518080/?tool=pubmed}}</ref> | ||
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**Homogenous, lightly eosinophilic glassy nuclei (biotin accumulation). | **Homogenous, lightly eosinophilic glassy nuclei (biotin accumulation). | ||
*Follicles | *Follicles | ||
**Cribriform, papillary, trabecular and solid patterns. | **[[Cribriform]], papillary, trabecular and solid patterns. | ||
**Columnar or cuboidal cells. | **Columnar or cuboidal cells. | ||
**Little colloid | **Little colloid | ||
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*Examples | *Examples | ||
***Well-differentiated fetal adenocarcinoma | ***Well-differentiated fetal adenocarcinoma | ||
***Papillary carcinoma, cribriform morular variant | ***Papillary thyroid carcinoma, cribriform morular variant (mutation in APC in familial variants) | ||
***Pancreatoblastoma | ***Pancreatoblastoma | ||
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===IHC=== | ===IHC=== | ||
Thyroid versus something else: | Thyroid versus something else: | ||
*Thyroglobulin +ve. | *Thyroglobulin +ve.<ref name=pmid23637102>{{Cite journal | last1 = Sathiyamoorthy | first1 = S. | last2 = Maleki | first2 = Z. | title = Cytomorphologic overlap of differentiated thyroid carcinoma and lung adenocarcinoma and diagnostic value of TTF-1 and TGB on cytologic material. | journal = Diagn Cytopathol | volume = 42 | issue = 1 | pages = 5-10 | month = Jan | year = 2014 | doi = 10.1002/dc.22997 | PMID = 23637102 }}</ref> | ||
*TTF-1 ([[thyroid transcription factor-1]]) +ve. | *TTF-1 ([[thyroid transcription factor-1]]) +ve. | ||
*CD15 +ve.{{fact}} | *CD15 +ve.{{fact}} | ||
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PTC versus benign:<ref>{{Cite journal | last1 = Mataraci | first1 = EA. | last2 = Ozgüven | first2 = BY. | last3 = Kabukçuoglu | first3 = F. | title = Expression of cytokeratin 19, HBME-1 and galectin-3 in neoplastic and nonneoplastic thyroid lesions. | journal = Pol J Pathol | volume = 63 | issue = 1 | pages = 58-64 | month = Mar | year = 2012 | doi = | PMID = 22535608 }}</ref> | PTC versus benign:<ref>{{Cite journal | last1 = Mataraci | first1 = EA. | last2 = Ozgüven | first2 = BY. | last3 = Kabukçuoglu | first3 = F. | title = Expression of cytokeratin 19, HBME-1 and galectin-3 in neoplastic and nonneoplastic thyroid lesions. | journal = Pol J Pathol | volume = 63 | issue = 1 | pages = 58-64 | month = Mar | year = 2012 | doi = | PMID = 22535608 }}</ref> | ||
*HBME-1 +ve (strong, diffuse). | *HBME-1 +ve (strong, diffuse). | ||
*CK19 +ve (strong, diffuse). | *[[CK19]] +ve (strong, diffuse). | ||
*Galectin-3 +ve (strong, diffuse). | *Galectin-3 +ve (strong, diffuse). | ||
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