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Thyroid gland
Papillary carcinoma - general

Reviewer: Shahidul Islam, M.D., Ph.D. (see Reviewers page)
Revised: 14 June 2013, last major update March 2009
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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Epidemiology
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Clinical features
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Radiology images
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CT scan
With lymph node metastasis
Contributed by Dr. Mark R. Wick
Prognostic factors
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Case reports
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Treatment
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Gross description
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Gross images
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Multifocal tumor
Lobulated tumor with central scar and infiltrative borders
Yellow partially encapsulated tumor with granulated cut surface
White cut surface and irregular borders
Expansile gray-white tumor
Images from AFIP:
Bisected thyroid lobe
Large tumor has invasive features
Tumor has abundant nodular fasciitis-like stroma
Metastasis to brain causing neurologic symptoms
Metastases to lymph node
Contributed by Dr. Mark R. Wick
Classical type - Contributed by Dr. Mark R. Wick
Micro description
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Micro images
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Architectural patterns:
Papillary architecture with fibrovascular cores
Low power papillary architecture
Papillary architecture with ground glass nuclei
Papillary architecture
Various images
Contributed by Dr. Mark R. Wick:
Classical type
In cervical lymph node
Images from AFIP:
Papillae show hyalinization of stroma
Papillary pattern on left, follicular pattern on right
Glomeruloid pattern due to tight packing of papillae
Solid growth pattern with ground glass nuclei
Typical low-power appearance
Typical growth pattern
High-grade papillary carcinoma
Multicentric focus of papillary carcinoma
Nuclear features (AFIP):
Papillae are lined by cuboidal to low columnar cells
Various images
Different fixatives
Images from other sources: ground glass nuclei and nuclear grooves
Psammoma bodies (AFIP):
Heavily calcified with well defined concentric laminations
Numerous psammoma bodies
Single necrotic cell in center has beginning calcification
Psammoma body in normal appearing thyroid
In center of papillae
In tumor with solid growth but with ground glass nuclei
Ground glass nuclei and psammoma bodies (other source)
Psammoma bodies are embedded in dense, fibrous tissue
Other features (AFIP):
Marked lymphocytic infiltrate
Vascular invasion (unusual finding)
Clear cell change
Clear cell change (follicular variant)
Squamous metaplasia with keratin pearl
Other features (other sources):
Aggressive spindle cell transformation
Squamous cell metaplasia
With other disorders:
Papillary carcinoma in Hashimoto’s thyroiditis (AFIP)
Papillary carcinoma in follicular adenoma (AFIP)
Arising from thyroglossal duct cyst
Invasion / metastases:
Parathyroid gland invasion
Capsular invasion (van Gieson)
Cervical lymph node - marginal sinus (AFIP)
Cervical lymph node
Lung metastasis - exuberant papillary architecture (AFIP)
Pituitary gland metastasis
Cervical lymph node with follicular growth pattern (AFIP)
Stain images:
CK19
HBME1 and CK19
HBME
H&E, HBME and CK19
Galectin-3
RET
Estrogen receptor (fig A / B)
Thyroglobulin+ in cytoplasm (AFIP)
Keratin+ (AFIP)
Virtual slides
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Various images
Papillary carcinoma with Hashimoto's thyroiditis
Positive stains
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Negative stains
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Electron microscopy description
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Electron microscopy images
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Images from AFIP:
Tall cuboidal cells
Tumor was metastatic to lymph node
Molecular / cytogenetics description
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Molecular / cytogenetics images
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RET-PTC1 rearrangement
Videos
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"Histopathology Thyroid -- Papillary carcinoma"
by John R. Minarcik, M.D.


"Histopathology Thyroid -- Hashimoto thyroiditis, papillary carcinoma"
by John R. Minarcik, M.D.

Differential diagnosis
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Additional references
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End of Thyroid gland > Papillary carcinoma - general


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