Columnar Cell Variant of Papillary Thyroid Carcinoma: A Clinicopathologic Analystis

Background: Papillary Thyroid Carcinoma (PTC) is the Most common thyroid malignancy disease, and it is more common in females. It happened in any age. Mean age at diagnosis is approximately 40 years old. There is history of neck irradiation in 5–10% patients. And non-neoplastic gland may show nuclear aberrations as a result. There is increased incidence in Hashimoto's thyroiditis, but not clear whether there is an increased incidence in Graves' disease. Columnar cell variant of papillary thyroid carcinoma is the rare subtype of PTC, which is reportedly about 0.17%. CCV-PTC was reported in 1986 by Evans for the first time. It is different from the typical papillary carcinoma, not only in morphology but also in biological behavior, and is more aggressive than typical papillary carcinoma. Objective: To study the clinical-pathological links and features of papillary thyroid carcinoma (Columnar cell variant) (CCV-PTC). Methods: 4 cases of CCV-PTC from Chengde medical college affiliated hospital were retrospectively analyzed, to observe its clinical features, histological, immunophenotype, and metastasis. And the literature of CCV-PTC were reviewed. Results: Out of the 4 patients, two male patients of 70 and 53 years old, two female patients of 64 and 68 years old. Microscopically, tumor cells arranged in multistage papillary structure, with pseudostratified columnar epithelium, same to gastrointestinal and lung metastatic carcinoma. IHC: Ki-67(5-15%), calcitonin(-), TG(+), ck19(-), TTF-1(+), CgA(-), SyN(-),ck(+/-). Conclusion: CCV-PTC is a special subtype of PTC with a more aggressive biological behavior, particularly among older people, Immunohistochemical method is helpful for the diagnosis