Histopathological features of Papillary Thyroid Carcinoma with special emphasis on the significance of nuclear features in their diagnosis

• Published in: Archives of Medicine and Health Sciences 2014, Vol.2 (1), p.16-22
• Main Authors: Kunjumon, DeepaThomas, Upadhyaya, Krishnaraj
• Format: Article
• Language: English
• Subjects: Nuclear features; papillary carcinoma; variants
• ISSN: 2321-4848
• DOI: 10.4103/2321-4848.133786

Background: Papillary carcinoma (PTC) is the most common thyroid malignancy comprising 80-85%. In addition to papillary architecture, nuclear features like clear, ground glass or Orphan Annie-eyed appearance, oval shape, increased nuclear size, hypodense chromatin, intranuclear cytoplasmic inclusions, nuclear grooving, nuclear overlapping, and mitotic figures play a vital role in the diagnosis although some of the features may be seen in other diseases of thyroid. Objectives: To evaluate and establish the diagnostic significance of each nuclear feature in PTC. Settings and Design: Among the thyroidectomy specimens received in the department of pathology, only the PTC cases were chosen. Multiple sections were studied from the tumor by two different pathologists with a special emphasis on morphological and nuclear features. Statistical analysis: Fischer′s exact test was done to find the correlation between the grading of nuclear features and cell population. Materials and Methods: Forty-one PTC cases were studied. Many H and E-stained slides of the tumor were studied by two different pathologists, and average of both observers was analyzed with special reference to nuclear features in classical and other variants of PTC. Results: The study evaluated that the ground glass nuclei, nuclear grooving, and nuclear overcrowding were the most common features seen in all (100%) cases though percentage of cells exhibiting these features varied from tumor to tumor. Other features mentioned above were less frequently encountered (42%-95%). Conclusion: In PTC, especially in variants, nuclear features are of utmost importance as they have to be differentiated from other thyroid diseases presenting with similar architectural morphology. Hence, more tissue sections have to be screened.