Thyroid Papillary Carcinoma

Nodular Thyroid Differential

Benign nodular Goiter
Toxic nodules
Benign Neoplasms
Malignant Neoplasms

Papillary Carcinoma of the Thyroid

About 1% of all cancers
80% of all thyroid cancers
Can present in any age group
Mainly in adults, ages 20-40
Females more affected than males
Indolent and non-aggressive
Commonly, tumor may invade lymphatics leading to multifocal lesions, presenting with enlarged lymph nodes within the neck region (lymphadenopathy)
Vascular invasion rare

Thyroid Papillary Carcinoma Causes

Radiation
Autoimmune diseases, such as Graves disease
Certain genetic syndromes, such as familial adenomatous polyposis coli

Thyroid Papillary Carcinoma Subtypes

Encapsulated Variant – well encapsulated
Papillary Microcarcinoma
Follicular Variant – follicular architecture
Tall Cell Variant -
Columnar Cell Variant

Thyroid Papillary Carcinoma Gross Appearance

Can arise anywhere in gland
Average 2 cm
Appear as firm, white, lesions, often with scars and cysts
Presence of necrosis signifies an aggressive lesion
Can often see papillary foci

Thyroid Papillary Carcinoma Histology

Usually papilla
Psammoma bodies, which are collections of dead papillae cells, with calcium deposition

1. show lamellations which allows them to be differentiated from dystrophic calcifications
2. found within papilla cores or tumor stroma

Nuclei are round, clear and empty looking

1. often nuclei overlap with one another
2. grooves may be seen
3. spare chromatin
4. intranuclear inclusions

Areas of squamous differentiation

Thyroid Papillary Carcinoma Genetics

Monoclonal proliferation
RET oncogene rearrangements

Poor Prognosis
Male, young, large mass and presence of cells outside of thyroid

Thyroid Papillary Carcinoma Tumor Grading

Not used as far majority are low-grade, grade 1

Thyroid Papillary Carcinoma Immunohistochemistry Markers

Thyrogloblin
Cytokeratin-19
HBME-1

Cytokeratin
Epithelial cells

Thyroglobulin
Thyroid cancer

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