Atypical Histiocytoid Cells and Multinucleated Giant Cells in Fine-Needle Aspiration Cytology of the Thyroid Predict Lymph Node Metastasis of Papillary Thyroid Carcinoma

Choi, Ji Eun; Bae, Ja Seong; Lim, Dong-Jun; Jung, So Lyung; Jung, Chan Kwon

doi:10.3390/cancers11060816

Cited by 10 publications

(8 citation statements)

References 36 publications

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“…Except that, we noticed that cases which had the presence of MGC, numerous nuclei and high N/C ratio in it, tended to be larger in tumor size, had more lymph node involvement and extrathyroidal extension. Our results were close to the two previous studies 8,15 . We have presumed that if there were more cases with resection material, it would have a statistically positive effect on our results.…”

Section: Discussionsupporting

confidence: 90%

“…Our results were close to the two previous studies. 8,15 We have presumed that if there were more cases with resection material, it would have a statistically positive effect on our results. In cases which there is no doubt about the diagnosis of malignancy, it is highly possible to use the presence of MGC as an important data of prognostic value.…”

Section: Discussionmentioning

confidence: 89%

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The pursuit of understanding multinucleated giant cells in indeterminate and malignant thyroid cytology samples

Aykutlu

Aydın

Gündoğdu

2020

Diagnostic Cytopathology

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BACKGROUND: Multinucleated giant cell (MGC) present in a variety of non-neoplastic and neoplastic lesions of the thyroid on cytology samples. We aimed to investigate whether certain MGC features that can help us in routine cytopathology practice. METHOD: One hundred and thirty seven cases thyroid fine-needle aspiration material, which was diagnosed as indeterminate or malignant according to the Bethesda categorization, were reviewed. All cytomorphological features of the MGCs were documented. These features correlated with Bethesda categories and the final diagnosis of the subsequent surgical specimen. RESULTS: The presence of the MGCs was identified in 42% of the samples (58 cases-total 236 MGCs). Eighty eight of them (37%) had dense cytoplasm, 148 of them had foamy cytoplasm. The mean number of dense and foamy MGC per case was higher in the malignant category (3.2 for dense MGC and 6 for foamy MGC per case). All dense MGCs were found to be in patients with papillary thyroid carcinoma (PTC). Remarkably, follicular patterned lesions had less often dense MGC compared to papillary patterned lesions (16.6% and 46.8% respectively). We detected a nuclear irregularity in 49 dense MGC (55%), groove-like features in 24 dense MGC (27.2%), and presence of some material/cell in 8 dense MGC (9%). CONCLUSION: The presence of dense MGC is an important finding for guiding accurate Bethesda categorization, especially in indeterminate and malignant categories. Besides, the presence of some material or cell in MGCs cytoplasm can be an important indicator for the prognosis of the PTC cases. K E Y W O R D S cytology, indeterminate, malignant, multinucleated giant cells, papillary thyroid carcinoma 1 | INTRODUCTION Multinucleated giant cell (MGC) present in a variety of hyperplastic, inflammatory, and neoplastic lesions of the thyroid gland. 1-4 These cells are recognized as diagnostic criteria of the papillary thyroid carcinoma (PTC) however they are not specific. Their cell sizes, nuclear, and cytoplasmic features can vary in neoplastic conditions and the presence of MGC alone is not sufficient for definitive diagnosis. 5 Besides, there are some controversies about the origin of the cells. Some authors suggest that some MGCs may be epithelial, while others indicate that they are histiocytic lineage. 2-4,6-8 In daily practice, pathologists know the importance of finding MGC for malignancy diagnosis in thyroid cytology, however, they do not know exactly all the features of these cells that help us to

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 89%

The pursuit of understanding multinucleated giant cells in indeterminate and malignant thyroid cytology samples

Aykutlu

Aydın

Gündoğdu

2020

Diagnostic Cytopathology

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“…However, PTC is prone to metastasize to cervical lymph nodes, especially the central ones. Thus, a proportion of patients with PTC present unfavorable prognosis possibly because 20%-90% of PTC cases present with cervical lymph node metastasis (LNM) [5,6]. Moreover, cervical LNM is the main risk factor associated with high recurrence in patients with PTC.…”

Section: Introductionmentioning

confidence: 99%

Immune-related key gene CLDN10 correlates with lymph node metastasis but predicts favorable prognosis in papillary thyroid carcinoma

Xiang

Zhong

Chang

et al. 2020

Aging

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The functions of immune cells in lymph node metastasis (LNM) have attracted considerable attention. This study aimed to screen the key immune-related and LNM-related genes in PTC. In the discovery phase, the immune-related genes in LNM were screened by using bioinformatics methods. In the validation phases, the association of the genes with LNM was first confirmed in a cohort from The Cancer Genome Atlas and a cohort based on a tissue chip. Then, the relationship of the genes with immune cell infiltration was further explored. Consequently, CLDN10 was identified, and its high expression was correlated with the presence of LNM in PTC but predicted a favorable prognosis. High CLDN10 expression was positively correlated with the infiltration of several immune cells, such as B cells, CD8+T cells, and macrophages. High CLDN10 expression may improve the outcomes of patients with PTC by increasing immune cell infiltration, although it might be associated with LNM. In conclusion, although CLDN1 might be correlated with LNM, it may also increase the infiltration of immune cells, including CD8+T cells and macrophages, and improve the clinical outcomes of patients with PTC. The effects of tumor purity and immune cell infiltration need to be considered in prognosis evaluation.

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“…Multinucleated giant cells are found in various thyroid lesions including Hashimoto’s thyroiditis, granulomatous thyroiditis, palpation thyroiditis, and PTC [ 29 ]. Some studies have reported that multinucleated giant cells are rarely found in NIFTP and follicular adenoma [ 22 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Molecular Correlates and Nuclear Features of Encapsulated Follicular-Patterned Thyroid Neoplasms

et al. 2021

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Background Assessing nuclear features is diagnostically challenging in the aspect of thyroid pathology. The aim of this study was to determine whether pathologists could distinguish BRAF -like and RAS -like nuclear features morphologically and identify morphological features to differentiate thyroid tumors with RAS -like mutations from encapsulated papillary thyroid carcinoma (PTC) with predominant follicular growth and BRAF V600E mutation. Methods Representative whole slide images of 16 encapsulated thyroid tumors with predominant follicular growth were reviewed by 12 thyroid pathologists using a web browser-based image viewer. Total nuclear score was calculated from semi-quantitatively scored eight nuclear features. The molecular profile of RAS and BRAF genes was determined by Sanger sequencing. Results Total nuclear score ranging 0 to 24 could differentiate BRAF -like tumors from RAS -like tumors with a cut-off value of score 14. The interobserver agreement was the highest for the assessment of nuclear pseudoinclusions (NPIs) but the lowest for nuclear elongation and sickle-shaped nuclei. NPIs were found in tumors with BRAF V600E mutation, but not in tumors with RAS -like mutations. Total nuclear scores were significantly higher for tumors with BRAF V600E than for those with RAS -like mutations ( P <0.001). Conclusion Our results suggest that NPIs and high nuclear scores have diagnostic utility as rule-in markers for differentiating PTC with BRAF V600E mutation from benign or borderline follicular tumors with RAS -like mutations. Relaxation of rigid criteria for nuclear features resulted in an overdiagnosis of PTC. Immunostaining or molecular testing for BRAF V600E mutation is a useful adjunct for cases with high nuclear scores to identify true PTC.

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Atypical Histiocytoid Cells and Multinucleated Giant Cells in Fine-Needle Aspiration Cytology of the Thyroid Predict Lymph Node Metastasis of Papillary Thyroid Carcinoma

Cited by 10 publications

References 36 publications

The pursuit of understanding multinucleated giant cells in indeterminate and malignant thyroid cytology samples

The pursuit of understanding multinucleated giant cells in indeterminate and malignant thyroid cytology samples

Immune-related key gene CLDN10 correlates with lymph node metastasis but predicts favorable prognosis in papillary thyroid carcinoma

Molecular Correlates and Nuclear Features of Encapsulated Follicular-Patterned Thyroid Neoplasms

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