Abstract
#Anaplasticthyroidcarcinoma (ATC) is a highly aggressive but rare
#thyroidmalignancy. Cytologically it typically shows a mixture of three
cell groups, i.e. spindle cells, giant cells, and #squamoid/epithelioid
cells. But, when it is composed predominantly of spindle cells, the
diagnosis
of ATC may not be robust. Here we report a case of #thyroidanaplasticcarcinoma predominantly composed of spindle cells with its cytologic
features on liquid-based preparation. A 61-year old male visited our
hospital with a 7cm-sized thyroid nodule detected on a regular checkup.
The initial fine needle aspiration was unsuccessful showing only cystic
fluid. The patient underwent radiofrequency ablation (RFA) with
decrease in the size of the mass that, after six month, enlarged back
again. Left #lobectomy and #isthmusectomy was performed. Liquid-based
cytologic sample was prepared using the scraped material from the
resected mass. Cytologically, the predominant cells were spindle cells,
arranged in clusters or in single cells. They had enlarged nuclei with
vesicular chromatin with minimal chromatic clumping. The nucleoli
were small but prominent. Giant cells, squamoid cells, or large
pleomorphic cells were not present. The background was slightly necrotic
and
degenerative. When a thyroid FNA from a thyroid nodule reveals spindle
cells, differential diagnosis should include ATC, medullary carcinoma,
other sarcomas, reactive fibrosis in Riedel’s thyroiditis, etc. The
degree of cytologic atypia of the spindle cells, the presence of other
components
such as giant cells and squamoid/epithelioid cells, along with the
immunohistochemical staining for calcitonin, CEA, PAX-8, and/or TTF-1
can
readily differentiate ATC from others.
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