Cytological diagnosis of papillary thyroid carcinoma with tall cells on ThinPrep liquid‐based cytology

Background

The tall cell variant of papillary thyroid carcinoma (PTC‐TC) has been associated with aggressive features including extrathyroidal extension, higher rate of lymph node and distant metastases, and higher recurrence rate. We aimed to evaluate the cytomorphologic features of PTC‐TC on ThinPrep (TP) along with its diagnostic efficacy to detect PTC‐TC.

Methods

Preoperative cytology samples from 30 cases of histologically‐proven PTC‐TC and 30 classical PTC controls were selected for this study. TP preparations were evaluated for varying architectural and cytomorphologic features.

Results

Tall cells were present in the majority of PTC‐TC cases and were located at the periphery of cell clusters and as single cells. Cytoplasmic cuff along the periphery of cell clusters and soap‐bubble pseudoinclusions were very specific features of PTC‐TC, when present. PTC‐TC cases were more likely to show abundant oncocytic cytoplasm and distinct cell borders. Cytoplasmic tails were more likely to be present and more numerous in PTC‐TC. The presence of nuclear grooves, papillary architecture, and giant cells were not reliable distinguishing features of PTC‐TC vs controls.

Conclusion

Our results indicate that tall cell cytomorphologic and architectural features in PTC are identifiable on TP.

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