Cytology of high-grade papillary thyroid carcinoma

✍ Scribed by Zubair W. Baloch; Virginia A. LiVolsi

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 16 KB
• Volume: 21
• Category: Article
• ISSN: 8755-1039
• DOI: 10.1002/(sici)1097-0339(199910)21:4<302::aid-dc16>3.0.co;2-k

✦ Synopsis

We read with great interest the article by Ohori and Schoedel on the cytology of high-grade papillary thyroid carcinoma. 1 Two questions should be addressed.

First, a feature illustrated by their Figure 2 is the presence of neutrophils in the epithelium of tall-cell carcinoma. Our group previously reported the value of this feature in cytologic diagnosis of tall-cell papillary cancer. 2 It has been speculated that this finding may reflect secretion of specific cytokines by this subset of tumors, similar to interleukin 6 secretion by anaplastic thyroid carcinoma. Did the authors note neutrophilic infiltration of the cellular groups in their other cases?

Secondly, the authors should define pathologically ''poorly differentiated papillary carcinoma'' (PDPC). They separated tall-cell variant, diffuse scelrosing variant from PDPC and indicate that they consider columnar-cell carcinoma as a distinct entity from papillary cancer. Indeed, the poorly differentiated thyroid carcinoma of Sakamoto et al. 3 was a heterogenous group and included the tall-cell variant of papillary carcinoma and Hu ¨rthle-cell carcinoma. What do the authors define as poorly differentiated carcinoma and/or poorly differentiated papillary carcinoma of the thyroid? Is it histologic grade or clinical aggressiveness of these tumors that prompts the term ''poorly differentiated papillary carcinoma?'' In our opinion, using one term for a histologically heterogenous group of tumors is both meaningless to pathologists who are expected to make a diagnosis with prognostic implications and somewhat dangerous to patients, since treating clinicians cannot determine appropriate treatment strategies without careful histopathologic diagnosis.