Thyroid gland
Papillary carcinoma
Columnar cell variant

Author: Shahidul Islam, M.D., Ph.D. (see Authors page)

Revised: 11 November 2016, last major update March 2009

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed search: papillary carcinoma thyroid WITH "columnar cell"

Cite this page: Columnar cell variant. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/thyroidcolumnarvariant.html. Accessed December 10th, 2016.
Definition / General
  • Tall cells with clear to eosinophilic cytoplasm, nuclear stratification and no / minimal papillary nuclear features
  • Rare, aggressive tumor with widespread dissemination (lung, brain, bone) and fatal outcome
  • Considered by some authors a distinct morphologic type but not a distinct clinical type (Cancer 1998;82:740)
Case Reports
Gross Description
  • Usually > 6 cm
Gross Images
Images hosted on other servers:

Tumor replaced most of thyroid and extended beyond thyroid

Micro Description
  • Often parallel cords of markedly elongated follicles forming tram tracks or train tracks
  • Tall cells (at least twice as tall as wide) with clear or vacuolated cytoplasm, squamoid morules, enlarged and elongated nuclei with nuclear stratification, coarse chromatin and small nucleoli
  • Nuclei lack polarity and are unevenly spaced within cells
  • Prominent mitotic figures
  • Usually no characteristic nuclear findings of papillary carcinoma
  • Usually sparse colloid
Micro Images
Images hosted on PathOut server:

Courtesy of Andrey Bychkov, M.D., Ph.D.

Epithelial prolif-
eration indicates
progression from
classic PTC

Lighter area on the right due to cytoplasmic vacuolation

Stratified tall epithelial cells with elongated nuclei

Classic features of PTC nuclei are not evident

Tumor penetrates
thyroid capsule
and vascular
spaces


Other images:

Contributed by Dr. Mark R. Wick

Columnar tumor
cells with striking
nuclear stratification
(AFIP)



Images hosted on other servers:

(A, B) Squamoid whorls or morules

Columnar cell type (top) versus tall cell type (bottom)

Variable thyroglobulin staining within same tumor


Various features

Various patterns

Morphologic features

Cytology Description
  • Moderately cellular
  • Sheets, papillary clusters and microfollicles of columnar cells with palisading oval nuclei containing uniformly finely granular chromatin, but no classic nuclear changes of papillary thyroid carcinoma
  • Usually no colloid (Acta Cytol 2004;48:73)
Negative Stains