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Cytomorphologic features of poorly differentiated thyroid carcinoma: a multi-institutional analysis of 40 cases
|Published in||Cancer. 2009, vol. 117, no. 3, p. 185-194|
|Abstract||BACKGROUND: Poorly differentiated thyroid carcinoma (PDTC) is an uncommon and aggressive malignancy. Despite the significant clinical implications of a diagnosis of PDTC, its cytomorphologic features have not been well defined. Statistical analysis was applied to a series of 40 PDTCs to identify a specific set of cytomorphologic features that characterized these tumors on fine-needle aspiration biopsy (FNAB). METHODS: In total, 40 thyroid FNABs that were highly diagnosed histologically as PDTC (19 insular carcinomas and 21 noninsular carcinomas) comprised the study group. A control group of 40 well differentiated thyroid neoplasms were selected for comparison. All FNABs were reviewed and scored for a series of 32 cytomorphologic features. The results were evaluated using univariate and stepwise logistic regression (SLR) analyses. RESULTS: In univariate analysis, 17 cytomorphologic features were identified that characterized the 40 PDTCs: insular, solid, or trabecular cytoarchitecture (P < .001); high cellularity (P = .007); necrosis (P = .025) or background debris (P = .025); plasmacytoid appearance (P = .0007); single cells (P < .0001); high nuclear/cytoplasmic ratio (P < .0001); scant cytoplasm (P = .03); nuclear atypia (P < .0001), including nuclear pleomorphism (P = .0052) and anisokaryosis (P < .0001); granular/coarse chromatin (P = .026); naked nuclei (P = .01); mitotic activity (P = .0001) and apoptosis (P < .0001); endothelial wrapping (P = .0053); and severe crowding (P < .0001). In logistic regression analysis, severe crowding (P = .0008) and cytoarchitecture (P < .0001) were identified as the most significant cytomorphologic features of PDTCs, and the combination of cytoarchitecture, severe crowding, single cells, and high nuclear/cytoplasmic ratio was the most predictive of PDTC. CONCLUSIONS: PDTCs have characteristic cytomorphologic features. By using logistic regression analysis, the features that were identified as the most predictive of PDTC were severe crowding, insular/solid/trabecular morphology, single cells, and high nuclear/cytoplasmic ratio.|
|Keywords||Adult — Aged — Aged, 80 and over — Analysis of Variance — Biopsy, Fine-Needle/*methods — Female — Humans — Immunohistochemistry — Keratins/analysis — Logistic Models — Male — Middle Aged — Nuclear Proteins/analysis — Thyroglobulin/analysis — Thyroid Gland/chemistry/*pathology — Thyroid Neoplasms/metabolism/*pathology — Transcription Factors/analysis|
|Research group||Groupe Pache Jean-Claude (pathologie clinique) (658)|
|BONGIOVANNI, Massimo et al. Cytomorphologic features of poorly differentiated thyroid carcinoma: a multi-institutional analysis of 40 cases. In: Cancer, 2009, vol. 117, n° 3, p. 185-194. https://archive-ouverte.unige.ch/unige:19690|