Papillary thyroid carcinoma with atypical histiocytoid cells on fine‐needle aspiration

Harshan, Manju; Crapanzano, John P.; Aslan, Deniz; Vazquez, Madeline F.; Saqi, Anjali

doi:10.1002/dc.20990

Cited by 25 publications

(18 citation statements)

References 11 publications

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“…These “histiocytoid cells” resemble histiocytes but usually show focal atypia, prominent nucleoli, and vacuolated cytoplasm. They may not have classical nuclear features of PTC but presence of nuclear grooves and pseudoinclusions have been reported . Cell block material would be helpful in difficult cases to perform immunohistochemical stains for histiocytic and epithelial markers.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic utility of cell block in fine needle aspiration cytology of thyroid gland

Vance

Durbin

Manglik

et al. 2019

Diagnostic Cytopathology

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Background: This study was conducted to evaluate the diagnostic utility of cell block material in fine needle aspiration (FNA) of thyroid nodules.Design: A total of 242 thyroid fine need aspirations (FNAs) were performed between January 2015 and December 2015. Of those, all consecutive thyroid FNA cases with cell blocks (n = 140) from 129 patients (age: 58.9 ± 12.8 years) are included in this study.Cytology slides and cell blocks are reviewed for adequacy assessment based on the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) and then categorizing them into TBSRTC diagnostic categories. These cases are divided into two groups, combined cytology and cell block (C + CB) and cytology without cell block (C).Results: In the first group (C + CB), a total 140 cases are categorized in TBSRTC as follows: I: 13 (9.3%) cases, II: 78 (55.7%) cases, III: 7 (5%), IV: 16 (11.4%), V: 3(2.2%) and VI: 23 (16.4%). In the second group (C), the cases are classified in TBSRTC as follows: I: 23 (16.4%) cases, II: 70 (50%), III: 7 (5%), IV: 16 (11.4%), V: 3 (2.2%) and VI: 21 (15%). Nondiagnostic rate was 7.1% lower in the first group (C + CB) as compared with second group (C) (First group: 9.3% vs second group: 16.4%, P = .0764).Conclusions: Combined use of cytology slides and cell block decreases the nondiagnostic rate up to 7.1% as compared with cytology without cell block.

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Section: Discussionmentioning

confidence: 99%

Diagnostic utility of cell block in fine needle aspiration cytology of thyroid gland

Vance

Durbin

Manglik

et al. 2019

Diagnostic Cytopathology

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“…35 In the only case that, to our knowledge, was tested immunohistochemically, the histiocytoid cells were positive for cytokeratin, suggesting that they were not of DC origin and more likely represented an unusual form of tumor cell. 36 The pathophysiology of the immune system's response to tumors like PTC is complex. The association of DCs with PTC has been linked to the production of chemokines, which attract peripheral DCs.…”

Section: Discussionmentioning

confidence: 99%

Association of CD1a‐positive dendritic cells with papillary thyroid carcinoma in thyroid fine‐needle aspirations

Pusztaszeri

Sadow

Faquin

2012

Cancer Cytopathology

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BACKGROUND:In contrast to other primary thyroid neoplasms and benign thyroid tissue, it has been demonstrated histologically that dendritic cells (DCs) are associated with papillary thyroid carcinoma (PTC). However, the presence and potential diagnostic value of DCs in thyroid fine-needle aspirations (FNAs) have not been previously described. METHODS: The authors quantitatively assessed for the presence of DCs that were positive for cluster of differentiation 1a (CD1a) (a 43-49 kD protein expressed on DCs and cortical thymocytes) in cytologic samples of histologically confirmed PTC (n ¼ 31) and in a control group of benign thyroid nodules (BTNs) (n ¼ 29) using immunocytochemical staining with antibodies against CD1a.A subset of the corresponding PTCs (n ¼ 11) and BTNs (n ¼ 10) from surgical resection specimens also were assessed immunohistochemically for both CD1a and Langerin (a type II transmembrane cell surface receptor produced by Langerhans cells).RESULTS: CD1a-positive DCs were identified in 97% PTCs (n ¼ 30 of 31 PTCs) in thyroid FNA specimens. DCs were largely present in 2 distinct patterns: either as isolated DCs in the background (n ¼ 29 of 31) and/or associated with tumor cells (n ¼ 30 of 31). Tumor-associated DCs (mean AE standard deviation: 6.44 AE 6.13 DCs per tumor cluster) exhibited multiple dendritic cytoplasmic processes extending over and between malignant cells within groups. The 3 PTC cases with the least DCs corresponded to the follicular variant at excision. In contrast, only 31% of BTNs (n ¼ 9 of 29 BTNs; P ¼ .0048) contained CD1a-positive DCs. When DCs were present in BTN, they were isolated primarily in the background (27%; n ¼ 8 of 29), although 17% of BTNs (n ¼ 5 of 29) contained rare DCs among thyrocytes, revealing both patterns in 4 cases. Both thyrocyte-associated DCs and background DCs were more numerous in PTC FNAs than in BTN FNAs, but only the thyrocyte-associated group of DCs was statistically significant (P < .0001 and P ¼ .1173, respectively). Similar findings were reported in histologic samples in which all PTCs examined (n ¼ 11 of 11) contained both CD1a-positive and Langerin-positive DCs; only 20% of BTNs (n ¼ 2 of 10) contained rare DCs. CONCLUSIONS: CD1a-positive DCs were present in FNA specimens of PTC, typically in close association with tumor cells, whereas they were rare in BTNs. The increased presence of CD1a-positive DCs in PTC may be a useful diagnostic adjuvant. Cancer (Cancer Cytopathol) 2013;121:206-13.

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“…In addition, well-defined intranuclear cytoplasmic pseudo-inclusions are not characteristic of LCs. In rare instances, however, PTCs with cystic degeneration are devoid of the typical malignant epithelial cells and composed instead of atypical histiocytoid cells mimicking benign histiocytes or LCs [43,44]. …”

Section: Discussionmentioning

confidence: 99%

Fine-Needle Aspiration of Primary Langerhans Cell Histiocytosis of the Thyroid Gland, a Potential Mimic of Papillary Thyroid Carcinoma

et al. 2013

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Background: The clinical presentation of Langerhans cell histiocytosis (LCH) as a primary solitary nodule in the thyroid gland is rare. As a result, there are few reports of its cytologic features in thyroid aspirates where it can pose a diagnostic pitfall. Case and Conclusion: To foster familiarity with its cytomorphology, we report the fine-needle aspiration biopsy (FNAB) findings of 3 specimens from 2 patients with LCH presenting as a solitary thyroid nodule. All aspirates contained numerous dispersed cells with prominent nuclear grooves, and the background showed a mixed pattern of chronic inflammation including scattered eosinophils. The aspirate from patient 1 raised a differential diagnosis that included chronic lymphocytic thyroiditis and a thyroglossal duct cyst, while the aspirate from patient 2 was interpreted as ‘suspicious for papillary thyroid carcinoma'. The diagnosis of LCH was confirmed in both patients after lobectomy and immunohistochemical studies that revealed positive reactivity for CD1a and S-100. LCH of the thyroid gland is rare and can pose significant diagnostic challenges, but increased familiarity with its characteristic cytomorphology can help in avoiding diagnostic pitfalls.

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Papillary thyroid carcinoma with atypical histiocytoid cells on fine‐needle aspiration

Cited by 25 publications

References 11 publications

Diagnostic utility of cell block in fine needle aspiration cytology of thyroid gland

Diagnostic utility of cell block in fine needle aspiration cytology of thyroid gland

Association of CD1a‐positive dendritic cells with papillary thyroid carcinoma in thyroid fine‐needle aspirations

Fine-Needle Aspiration of Primary Langerhans Cell Histiocytosis of the Thyroid Gland, a Potential Mimic of Papillary Thyroid Carcinoma

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