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Preoperative Cytologic Diagnosis of Warthin-like Variant of Papillary Thyroid Carcinoma

 Jisup Kim  ;  Beom Jin Lim  ;  Soon Won Hong  ;  Ju Yeon Pyo 
 Journal of Pathology and Translational Medicine, Vol.52(2) : 105-109, 2018 
Journal Title
 Journal of Pathology and Translational Medicine 
Issue Date
Biopsy, fine-needle ; Hashimoto disease ; Thyroid cancer, papillary ; Warthin-like variant
BACKGROUND: Warthin-like variant of papillary thyroid carcinoma (WLV-PTC) is a relatively rare variant of papillary thyroid carcinoma with favorable prognosis. However, preoperative diagnosis using fine-needle aspiration (FNA) specimens is challenging especially with lymphocytic thyroiditis characterized by Hürthle cells and lymphocytic background. To determine a helpful cytological differential point, we compared WLV-PTC FNA findings with conventional papillary thyroid carcinoma with lymphocytic thyroiditis (PTC-LT) and conventional papillary thyroid carcinoma without lymphocytic thyroiditis (PTC) regarding infiltrating inflammatory cells and their distribution. Preoperative diagnosis or potential for WLV-PTC will be helpful for surgeons to decide the scope of operation. METHODS: Of the 8,179 patients treated for papillary thyroid carcinoma between January 2007 and December 2012, 16 patients (0.2%) were pathologically confirmed as WLV-PTC and four cases were available for cytologic review. For comparison, we randomly selected six PTC-LT cases and five PTC cases during the same period. The number of intratumoral and background lymphocytes, histiocytes, neutrophils, and the presence of giant cells were evaluated and compared using conventional smear and ThinPrep preparations. RESULTS: WLV-PTC showed extensive lymphocytic smear with incorporation of thyroid follicular tumor cell clusters and frequent histiocytes. WLV-PTC was associated with higher intratumoral and background lymphocytes and histiocytes compared with PTC-LT or PTC. The difference was more distinct in liquid-based cytology. CONCLUSIONS: The lymphocytic smear pattern and the number of inflammatory cells of WLV-PTC are different from those of PTC-LT or PTC and will be helpful for the differential diagnosis of WLV-PTC in preoperative FNA.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
김지섭(Kim, Jisup) ORCID logo https://orcid.org/0000-0002-0742-5517
임범진(Lim, Beom Jin) ORCID logo https://orcid.org/0000-0003-2856-0133
홍순원(Hong, Soon Won) ORCID logo https://orcid.org/0000-0002-0324-2414
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