Anaplastic Thyroid Carcinoma: Cytomorphologic Features on Fine-Needle Aspiration and Associated Diagnostic Challenges

Abstract Objectives Anaplastic thyroid carcinoma (ATC) is an aggressive malignancy, and early diagnosis, often aided by fine-needle aspiration (FNA), is key to improving patient prognosis. While the current literature describes some of the cytologic features (CFs) of this entity, a comprehensive exa...

Full description

Saved in:
Bibliographic Details
Published in:American journal of clinical pathology 2022-04, Vol.157 (4), p.608-619
Main Authors: Podany, Peter, Abi-Raad, Rita, Barbieri, Andrea, Garritano, James, Prasad, Manju L, Cai, Guoping, Adeniran, Adebowale J, Gilani, Syed M
Format: Article
Language:English
Subjects:
Apoptosis
Biopsy, Fine-Needle
Cancer
Carcinoma
Chromatin
Comparative analysis
Diagnosis
Editor's Choice
Humans
Inflammation
Malignancy
Medical diagnosis
Original
Pleomorphism
Prognosis
Retrospective Studies
Statistical analysis
Thyroid cancer
Thyroid carcinoma
Thyroid Carcinoma, Anaplastic - diagnosis
Thyroid Carcinoma, Anaplastic - pathology
Thyroid diseases
Thyroid Neoplasms - diagnosis
Thyroid Neoplasms - pathology
Tumor cells
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Objectives Anaplastic thyroid carcinoma (ATC) is an aggressive malignancy, and early diagnosis, often aided by fine-needle aspiration (FNA), is key to improving patient prognosis. While the current literature describes some of the cytologic features (CFs) of this entity, a comprehensive examination of the CFs has not yet been performed. Methods We retrospectively searched our electronic database for ATC cases with available slides between January 2008 and December 2019. Cases were examined for 22 CFs and compared with a control group of differentiated thyroid carcinoma. Results A total of 18 ATC cases meeting our inclusion criteria were identified. Most cases showed moderate to high cellularity (83%) and epithelioid cytomorphology (83%). Architecture included either predominantly groups/clusters of tumor cells (56%) or single tumor cells (44%). The other CFs were as follows: nuclear enlargement (100%), nuclear crowding (89%), nuclear membrane irregularities (100%), multinucleated tumor cells (33%), and background acute inflammatory cells (50%). Of the CFs examined, statistically significant differences between ATC and the control groups were found in the following: nuclear pleomorphism, coarse/clumped chromatin, macronucleoli, apoptosis, and necrosis. Conclusions Identification of key CFs in FNA coupled with the clinical history aids in the diagnosis of ATC and helps distinguish it from other mimickers.
ISSN:0002-9173
1943-7722
DOI:10.1093/ajcp/aqab159