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Solid variant of papillary thyroid carcinoma: an under-recognized entity.

Ryuji Ohashi1

  • 1Department of Diagnostic Pathology, Nippon Medical School Musashi-Kosugi Hospital, Kanagawa 211-8533, Japan.

Endocrine Journal
|January 28, 2020
PubMed
Summary

Solid variant of papillary thyroid carcinoma (SVPTC) is a rare PTC subtype. While sharing some features with poorly differentiated thyroid carcinoma, SVPTC can be distinguished by specific histological markers and genetic mutations.

Keywords:
Papillary carcinomaSolid variantThyroid

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Area of Science:

  • Endocrinology
  • Oncology
  • Pathology

Background:

  • Solid variant of papillary thyroid carcinoma (SVPTC) is a rare morphological variant of papillary thyroid carcinoma (PTC).
  • SVPTC exhibits distinct histological features, including predominant solid nests, while retaining PTC cytological characteristics.
  • Differentiating SVPTC from poorly differentiated thyroid carcinoma (PDTC) is crucial, based on the absence of necrosis, severe nuclear atypia, and a higher mitotic index.

Purpose of the Study:

  • To review and discuss current knowledge on SVPTC.
  • To emphasize the histopathological features of SVPTC.
  • To highlight diagnostic criteria and potential associations.

Main Methods:

  • Histopathological analysis of SVPTC.
  • Cytological examination of fine needle aspiration smears.
  • Immunohistochemical staining for CK19 and HBME-1.
  • Review of genetic alterations (RET/PTC, BRAF mutations).

Main Results:

  • SVPTC cells present in cohesive or trabecular clusters, with some discohesiveness and absence of necrosis.
  • Immunohistochemical markers CK19 and HBME-1 show decreased expression in SVPTC solid nests.
  • SVPTC is associated with RET/PTC3 rearrangement in radiation-exposed pediatric patients and BRAF mutations in some adults.
  • SVPTC may show a slightly higher incidence of metastasis and recurrence than conventional PTC, with comparable overall survival.

Conclusions:

  • SVPTC is a distinct entity within papillary thyroid carcinoma, characterized by specific histopathological and cytological findings.
  • Distinguishing SVPTC from PDTC relies on key differentiating features.
  • Understanding the genetic landscape and clinical behavior of SVPTC is essential for patient management.