Journal of Pathology and Translational Medicine

Original Article

Contribution of cytologic examination to diagnosis of poorly differentiated thyroid carcinoma: Na Rae Kim, Jae Yeon Seok, Yoo Seung Chung, Joon Hyop Lee, Dong Hae Chung; J Pathol Transl Med. 2020;54(2):171-178. Published online February 5, 2020; DOI: https://doi.org/10.4132/jptm.2019.12.03

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Background
The cytologic diagnosis of poorly differentiated thyroid carcinoma (PDTC) is difficult because it lacks salient cytologic findings and shares cytologic features with more commonly encountered neoplasms. Due to diverse cytologic findings and paucicellularity of PDTC, standardization of cytologic diagnostic criteria is limited. The purpose of this study is to investigate and recognize diverse thyroid findings of fine needle aspiration (FNA) cytology and frozen smear cytology in diagnosis of this rare but aggressive carcinoma.
Methods
The present study included six cases of FNA cytology and frozen smears of histologically diagnosed PDTCs.
Results
PDTC showed cytologic overlap with well-differentiated thyroid carcinomas (WDTCs). Five of six cases showed dedifferentiation arising from well differentiated thyroid carcinomas. Only one de novo PDTC showed highly cellular smears composed of discohesive small cells, high nuclear/cytoplasmic (N/C) ratio, prominent micronucleoli, and irregular nuclei. Retrospectively reviewed, these findings are highly suspicious for PDTC. Cytologic findings of nuclear atypia, pleomorphism, and irregularity were frequently found, whereas scattered small cells were seen only in the de novo case.
Conclusions
Heterogeneous cytologic findings of PDTCs are shared with those of WDTCs and contribute to difficult preoperative cytologic diagnoses. Most PDTCs show dedifferentiation from WDTCs. Albeit rare, de novo PDTC should be considered with cytology showing discohesive small cells with high N/C ratio. This will enable precise diagnosis and prompt treatment of this aggressive malignancy

Citations

Citations to this article as recorded by

Non-papillary thyroid carcinoma diagnoses in The Bethesda System for Reporting Thyroid Cytopathology categories V and VI: An institutional experience
Myunghee Kang, Na Rae Kim, Jae Yeon Seok
Annals of Diagnostic Pathology.2024; 71: 152263. CrossRef
An Unexpected Finding of Poorly Differentiated Thyroid Carcinoma in a Toxic Thyroid Nodule
Kimberly Yuang, Huda Al-Bahadili, Alan Chang
JCEM Case Reports.2023;[Epub] CrossRef
Revisiting the cytomorphological features of poorly differentiated thyroid carcinoma: a comparative analysis with indeterminate thyroid fine-needle aspiration samples
Yazeed Alwelaie, Ali Howaidi, Mohammed Tashkandi, Ahmad Almotairi, Hisham Saied, Moammar Muzzaffar, Doaa Alghamdi
Journal of the American Society of Cytopathology.2023; 12(5): 331. CrossRef
Characterization of the genomic alterations in poorly differentiated thyroid cancer
Yeeun Lee, SeongRyeol Moon, Jae Yeon Seok, Joon-Hyop Lee, Seungyoon Nam, Yoo Seung Chung
Scientific Reports.2023;[Epub] CrossRef

Brief Case Report

Fine Needle Aspiration Cytology of Postoperative Spindle Cell Nodule in Neck after Thyroidectomy: A Case Report: Myunghee Kang, Seung Yeon Ha, Hyun Yee Cho, Jungsuk An, Dong Hae Chung, Yoo Seung Chung; Korean J Pathol. 2013;47(1):89-91. Published online February 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.1.89

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Citations

Citations to this article as recorded by

Post-surgical thyroid bed myofibroma simulating a recurrent papillary thyroid carcinoma: A case report and review of the literature
Jun Hyeon Park, Kyung Sik Yi, Chi-Hoon Choi, Yook Kim, Jisun Lee, Yeongtae Park, Ok-Jun Lee
Medicine.2024; 103(2): e36945. CrossRef
USP6‐associated neoplasm as a tentative subset of postoperative spindle cell nodule
Lili Sun, Zehua Zhao, Yanmei Zhu
Histopathology.2023; 82(4): 587. CrossRef
Diagnostic Performance of Core Needle Biopsy for Characterizing Thyroidectomy Bed Lesions
So Yeong Jeong, Jung Hwan Baek, Sae Rom Chung, Young Jun Choi, Dong Eun Song, Ki-Wook Chung, Won Woong Kim, Jeong Hyun Lee
Korean Journal of Radiology.2022; 23(10): 1019. CrossRef

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