Thyroid gland
Papillary carcinoma
Tall cell variant

Topic Completed: 1 March 2009

Minor changes: 31 March 2020

Copyright: 2002-2018,, Inc.

PubMed Search: Papillary carcinoma tall cell variant

Shahid Islam, M.D., Ph.D.
Page views in 2019: 5,200
Page views in 2020 to date: 1,855
Cite this page: Islam S. Papillary carcinoma - tall cell variant. website. Accessed May 24th, 2020.
Definition / general
  • Cells twice as tall as wide comprise 50% of tumor, have abundant eosinophilic cytoplasm and papillary nuclear features
  • 4 - 10% of papillary thyroid carcinomas (World J Surg 2008;32:1535)
  • Usually older age
  • Often underdiagnosed (Thyroid 2008;18:1179)
Clinical features
Prognostic factors
Case reports
Gross description
  • Usually large (> 6 cm) with extrathyroidal extension
Microscopic (histologic) description
  • Intricate, well formed, long papillae lined by single layer of tall columnar cells (height is twice width) with sharply delineated cell borders, intensely eosinophilic, finely granular cytoplasm
  • Nuclei are enlarged with grooves, chromatin clearing and pseudoinclusions but no nuclear stratification
  • Often with lymphocytic thyroiditis, prominent vascular invasion, mitotic activity
  • No squamoid morules
  • Note: tall cells should comprise > 50% of tumor cells for diagnosis
Microscopic (histologic) images

Images hosted on PathOut server:

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

Extensive necrosis
can be a sign
of high grade

Necrotic degeneration

High epithelium with eosinophilic cytoplasm

Epithelium is twice as tall as wide

Elongated papillae

Tram-track pattern

AFIP images:

Abundant acidophilic cytoplasm

Tall epithelial cells

Images hosted on other servers:

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

"Frosted glass core" appearance

RET staining

Collision tumor with Hürthle cell carcinoma

Cytology description
  • Tall cells (30% of aspirated cells) with well defined granular eosinophilic cytoplasm, nuclei with nuclear grooves or intracytoplasmic inclusions which resemble "soap bubbles" due to multiple inclusions in same nucleus (Diagn Cytopathol 2002;27:143)
  • Also lymphocytes (Acta Cytol 2004;48:325)
Cytology images

Images hosted on other servers:

Some cells are elongated
with cytoplasmic tails

Metastasis to pancreas:

Left: nuclear groove (long arrow)
and intranuclear inclusion (short arrow);
right: intranuclear inclusion (arrow)

Cell block shows papillary
cluster of tall tumor cells with
abundant oncocytic cytoplasm

Molecular / cytogenetics description
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