Cytomorphology of Warthin‐like variant of papillary thyroid carcinoma: A diagnosis not to be missed

Agrawal, Shailesh; Singh, Abhijeet; Jat, Bhanwar Lal; Phulware, Ravi Hari

doi:10.1111/cyt.13037

Cited by 3 publications

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“…3(2) (2022) pp.57-61 | https://www.archivosdepatologia.com sospecha de carcinoma papilar Warthin-like es el carcinoma papilar clásico con tiroiditis de Hashimoto; sin embargo, en estos casos, se apreciaría un aumento del infiltrado linfocitario más abundante en las zonas adyacentes no neoplásicas que en las propias papilas tumorales del carcinoma papilar, aunque, en ocasiones, el infiltrado alcance el estroma tumoral, sin llegar a los ejes conectivo-vasculares de las papilas. (10) En relación con estas dos últimas sospechas diagnósticas, Yeo et al, en su estudio de 2139 pacientes con diagnóstico de carcinoma papilar de tiroides, de los cuales 40 eran subtipo Warthin-like, refieren que solo el 27 % de ellos presentaban TH, mientras que el 80 % de estos mismos casos presentaban TH2. (11) Es importante no excluir del diagnóstico diferencial otras posibilidades como el carcinoma papilar clásico con cambios oncocíticos (se descarta por la ausencia de células linfoplasmocitarias en las papilas neoplásicas), el carcinoma folicular con cambios oncocíticos (las células de este tipo tumoral carecen de las características nucleares del carcinoma papilar de tiroides), el subtipo oncocítico de carcinoma papilar (también carece de infiltrado linfoide en los ejes papilares), el subtipo de células columnares (se caracteriza porque los oncocitos que revisten las papilas son tres veces más grandes que el resto de células, y carecen también de infiltrado linfocitario) (12) y el carcinoma de células de Hürthle (que, igual que los anteriores, carece de infiltrado linfoplasmocitario).…”

Section: Discussionunclassified

Carcinoma papilar de tiroides. Reporte de dos casos de un subtipo poco frecuente

Carrasco¹,

Moreno²,

Sánchez

et al. 2022

ArchPat

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El carcinoma papilar de tiroides es la neoplasia tiroidea maligna más frecuente, representando en torno al 80 % de los casos. El subtipo Warthin-like es muy poco frecuente dentro de los subtipos de este carcinoma, presente en un porcentaje inferior al 2 % de ellos. Se caracteriza por la presencia de papilas tapizadas por células foliculares que tienen abundante citoplasma eosinófilo (oncocitos) y en las cuales, característicamente, los ejes fibrovasculares muestran abundante infiltrado linfoplasmocitario, lo que recuerda al tumor de Warthin, originado en la glándula parótida. Esta patología propone un interesante diagnóstico diferencial con otros subtipos de carcinoma papilar de tiroides y con la tiroiditis linfocítica crónica o tiroiditis de Hashimoto, la cual se presenta en un amplio porcentaje en la tiroides no neoplásica de los pacientes con carcinoma papilar de tiroides. El objetivo de este artículo es reportar dos casos de carcinoma papilar de tiroides subtipo Warthin-like.

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Section: Discussionunclassified

Carcinoma papilar de tiroides. Reporte de dos casos de un subtipo poco frecuente

Carrasco¹,

Moreno²,

Sánchez

et al. 2022

ArchPat

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Warthin-like Papillary Thyroid Carcinoma: A Case Report and Review of the Literature

Aparnna,

Ayyanar,

Sable

et al. 2024

Int J Surg Pathol

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Warthin-like subtype of papillary thyroid carcinoma (WLPTC) is a rare subtype of papillary thyroid carcinoma. This PTC subtype shows some pattern resemblance to Warthin tumors of the salivary gland, which confers its name but is a not genetically similar to salivary Warthin tumor, with the most frequent genetic change in WLPTC being BRAF p.V600E, the most frequent genetic driver of PTC. Warthin-like subtype of papillary thyroid carcinoma is found to have a favorable prognosis. We report a 44-year-old woman who presented with anterior neck swelling and elevated levels of antithyroid peroxidase antibodies. Fine-needle aspiration cytology showed features of papillary thyroid carcinoma and lymphocytic thyroiditis. On histopathological examination, thyroid follicular cells have oncocytic cytoplasm with infiltration of the tumor and fibrovascular cores by a dense lymphoplasmacytic infiltrate. Numerous multinucleated giant cells in the tumor are a notable feature. The final diagnosis is Warthin-like papillary thyroid carcinoma arising in association with chronic lymphocytic (Hashimoto) thyroiditis. Along with this case report, we perform a literature review of WLPTC between 2010 and 2024.

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Warthin-like papillary thyroid carcinoma: a case report and comprehensive review of the literature

et al. 2023

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BackgroundPapillary Thyroid Carcinoma (PTC) is the most frequent endocrine malignancy with a variety of histological presentations. Warthin-like Papillary Thyroid Carcinoma (WLPTC) is an uncommon neoplasm that is recognized as a distinct subtype of PTC in the WHO classification of thyroid tumors. In this report, we present a novel case of WLPTC in a female patient and provide an in-depth review of the available literature on its clinical, pathological, and therapeutic characteristics.Case presentationA 27-year-old female patient was referred for neck swelling. Ultrasound showed two suspicious thyroid nodules leading to a thyroidectomy. She was diagnosed with intermediate-risk bifocal foci of classic PTC and WLPTC, arising from a background of chronic lymphocytic thyroiditis (CLT). This pT1b(m) N1b M0 malignancy was treated with adjuvant isotopic ablation and suppressive thyroxine therapy. The 1-year outcomes were favorable.Literature reviewIt covered articles published from 1995 to 2022, by searching PubMed and Google Scholar using specific terms. Out of 148 articles reviewed by two authors, 25 relevant articles were selected, including 13 case reports and 12 case series. The study included 150 cases of WLPTC. Data related to clinical presentation, imaging, histological features, management, and outcomes, were extracted. The mean age of diagnosis was 39 years, with a female predominance. The most common clinical presentation was neck swelling. Thyroid autoimmunity was positive in 71.6% of patients. Lymph node metastases were present in 28% of cases, with no reported distant metastases. Overall, the outcomes were favorable.ConclusionWLPTC shares similar clinical and radiological presentations as classic PTC. The hallmark histological features of WLPTC are papillae lined with oncocytic tumor cells with papillary nuclear changes and lymphoid stroma. WLPTC is almost constantly associated with CLT. The management of WLPTC aligns with that of classic PTC with comparable stage and risk category, often resulting in favorable outcomes.

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Cytomorphology of Warthin‐like variant of papillary thyroid carcinoma: A diagnosis not to be missed

Abstract: The authors have elaborated the cytological features of Warthin‐like variant of papillary thyroid carcinoma (WLPTC) presenting unusually with nodal metastasis in a 43‐year‐old lady, and which was reported on cytology as papillary thyroid carcinoma (PTC) with lymphocytic thyroiditis.

Cited by 3 publications

References 4 publications

Carcinoma papilar de tiroides. Reporte de dos casos de un subtipo poco frecuente

Carcinoma papilar de tiroides. Reporte de dos casos de un subtipo poco frecuente

Warthin-like Papillary Thyroid Carcinoma: A Case Report and Review of the Literature

Warthin-like papillary thyroid carcinoma: a case report and comprehensive review of the literature

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