Aims The definition of papillary thyroid carcinoma, solid variant (PTC‐SV) varies from >50% to 100% of solid/trabecular/insular growth (STI). We aimed to identify prognostic factors and to establish an appropriate STI cutoff for PTC‐SV in this multi‐institutional study of 156 PTCs with STI. Results Nodal metastases were seen in 18% and were associated with a higher percentage of papillary and STI. When substratified by infiltration/encapsulation status, the STI percentage did not impact the risk of nodal metastasis. pN1 stage was seen in 51% of infiltrative tumours and 1% of encapsulated lesions. Overall, PTC with STI had an excellent prognosis. The 10‐year disease‐free survival (DFS) was 87% in the entire cohort, 94% in encapsulated lesions, and 76% in infiltrative tumours. The STI percentage did not impact DFS. Fifty‐four patients had noninvasive encapsulated lesions with 2–100% STI. None developed recurrence. Encapsulated lesions were enriched with RAS mutations (54%), whereas infiltrative lesions lacked RAS mutations (4%). The BRAF V600E mutation was an infrequent event, being seen in 11% of the entire cohort. Conclusion In PTC with STI, the determining factor for nodal metastasis and DFS is the encapsulation/infiltration status rather than the STI percentage. Encapsulated noninvasive tumours with STI follow an indolent course with a very low risk of nodal metastasis and recurrence. Overall, PTC with STI has an excellent prognosis, with a 10‐year disease‐specific survival (DSS) and DFS of 96% and 87%, respectively. Therefore, the classification of SV‐PTC as an aggressive PTC subtype may be reconsidered.

loops of small bowel. No discrete lymph nodes were identified and no free air or free fluid was seen within the abdominal cavity. A colonoscopy study was scheduled in view of the CT findings, which showed a friable, stenotic tumour, 68 cm from the anal verge, which extended 10 cm proximally obstructing approximately 80% of the bowel lumen. Histological examination of a biopsy of the lesion showed adenocarcinoma. Other significant laboratory findings included decreased haemoglobin (10.6 mg/dL), elevated carcinoembryonic antigen (19.46 ng/ml) and C-reactive protein (36.9 mg/dL).Because of the CT findings, the working preoperative diagnosis of this patient was stage IV colon cancer. Definitive surgical management in this case was guided by not only the radiological staging, but also by intra-operative findings, which showed loops of small bowel firmly adherent to the descending colon, possibly representing an advanced stage of the disease. A left hemicolectomy with en-block resection of the jejunum was performed. The surgical specimen was subsequently submitted to the histopathology laboratory. Colonic Carcinoma Associated with Malakoplakia

BackgroundGynecologic sex cord‐stromal tumors (SCSTs) arise from sex cords of the embryonic gonad and may display malignant behavior. We describe the cytomorphologic features of SCSTs in females, including adult and juvenile granulosa cell tumors (AGCTs and JGCTs), Sertoli‐Leydig cell tumors (SLCTs), and steroid cell tumors (SCTs).MethodsWe retrieved available cytology slides from females with a histologic diagnosis of sex cord‐stromal tumor between 2009 and 2020 from institutional archives and reviewed their cytoarchitectural features.ResultsThere were 25, 2, 2, and 1 cytology specimens from 19, 2, 2, and 1 patients (aged 7‐90 years, median 57 years) with AGCT, JGCT, SLCT, and SCT, respectively. Features common to all SCSTs included 3‐dimensional groups, rosettes, rare papillary fragments, abundant single cells and naked nuclei. Rosettes and a streaming appearance of cell groups were only seen in AGCTs, which also rarely featured eosinophilic hyaline globules and metachromatic stroma. AGCTs exhibited high nuclear:cytoplasmic (N:C) ratios, with mild nuclear pleomorphism, uniform nuclei with finely granular chromatin, nuclear grooves and small nucleoli; in contrast, other SCSTs lacked rosettes and nuclear grooves and had generally lower N:C ratios, greater nuclear pleomorphism, coarse chromatin and more abundant cytoplasm. Mitotic figures, necrosis, and inflammation were rarely identified.ConclusionsAGCTs show cytomorphologic features that are distinct from those of other SCSTs. Careful evaluation of the cytological features and ancillary studies (eg, immunochemistry for FOXL2, inhibin and calretinin, or sequencing for FOXL2 mutations) can aid in the accurate diagnosis of these tumors.

No abstract