Thyroid & parathyroid
Papillary thyroid carcinoma
Other subtypes
Macrofollicular
Author: Shahid Islam, M.D., Ph.D.
Last author update: 1 March 2009
Last staff update: 12 January 2021
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: papillary carcinoma macrofollicular variant
Table of Contents
Definition / general | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Differential diagnosisCite this page: Islam S. Macrofollicular. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/thyroidmacrofollicular.html. Accessed April 19th, 2024.
Definition / general
- Macrofollicles (large dilated follicles) > 50% of cross sectional area, with papillary nuclear features
- Very rare; similar clinical features as classic papillary carcinoma (female predominant, occasional nodal metastases, few deaths)
- May have minor (< 5%) insular component that does not appear to affect prognosis (Cancer 1997;80:1110)
Gross description
- Mean 3 cm, often encapsulated
Microscopic (histologic) description
- Frequent macrofollicles (> 50% of cross sectional area) and foci of follicular variant of papillary carcinoma, all with prominent, large ground glass nuclei and nuclear grooves (Hum Pathol 1991;22:1195)
- Also cells with large but less pale nuclei with stippled chromatin, or cuboidal cells with hyperchromatic nuclei
Microscopic (histologic) images
Contributed by Shuanzeng Wei, M.D., Ph.D.
Nodal metastasis, macrofollicular variant PTC
Nodal metastasis, macrofollicular variant PTC
Cytology description
- Moderate to highly cellular with micro- and macrofollicles with thick colloid
- Papillary nuclear changes often absent or focal
- May resemble goiter (Diagn Cytopathol 2007;35:560, Cancer 1998;84:235)
Differential diagnosis
- Follicular adenoma: lined by flat epithelial cells with hyperchromatic nuclei
- Nodular hyperplasia
