Thyroid gland
Papillary carcinoma
Columnar cell variant

Topic Completed: 1 March 2009

Revised: 26 April 2019

Copyright: 2003-2018,, Inc.

PubMed Search: papillary carcinoma thyroid columnar cell

Shahid Islam, M.D., Ph.D.
Page views in 2018: 3,401
Page views in 2019 to date: 3,060
Cite this page: Islam S. Columnar cell variant. website. Accessed November 14th, 2019.
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:

Thyroid tumor replaced
most; extended beyond
thyroid (fig. 1B)

Microscopic (histologic) 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
Microscopic (histologic) images

Images hosted on PathOut server:

Contributed by Andrey Bychkov, M.D., Ph.D.

High Ki67

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

Contributed by Dr. Mark R. Wick

Other images

Columnar tumor
cells with striking
nuclear stratification

Images hosted on other servers:

Squamoid whorls or morules (fig. 5A, B)

Columnar cell type (top) versus tall cell type (bottom) (fig. 9)

Variable thyroglobulin staining within same tumor (fig. 7)

Various features (fig. 6A - D)

Various patterns (fig. 2A - D)

Morphologic features (fig. 3A - D)

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
Differential diagnosis
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