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Review
. 2019 Aug 2;11(8):1100.
doi: 10.3390/cancers11081100.

Critical Prognostic Parameters in the Anatomic Pathology Reporting of Differentiated Follicular Cell-Derived Thyroid Carcinoma

Bin Xu  1 , Ronald Ghossein  2
Affiliations
Review

Critical Prognostic Parameters in the Anatomic Pathology Reporting of Differentiated Follicular Cell-Derived Thyroid Carcinoma

Bin Xu et al. Cancers (Basel). .

Abstract

In the past decades, pathology reporting on thyroid carcinoma has evolved from a narrative approach to structured synoptic reports. Many histologic variables are present in the current synoptic reports that are crucial elements for initial risk stratification and clinical management. In this review, we compare and summarize the key prognostic pathologic characteristics utilized by the most influential clinical and pathologic guidelines from the American Thyroid Association (ATA), the National Comprehensive Cancer Network (NCCN), the current World Health Organization (WHO) classification of endocrine tumors (fourth edition), the current American Joint Committee on Cancer (AJCC) staging system (eighth edition), the College of American Pathologists (CAP) protocol, and the International Collaboration on Cancer Reporting (ICCR) dataset. The aim is to provide a comprehensive review focused on the definitions and prognostic impacts of these crucial pathologic parameters.

Keywords: AJCC staging; capsular invasion; extrathyroidal extension; lymphovascular invasion.

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Conflict of interest statement

No competing financial interests exist for all contributory authors.

Figures

Figure 1
Figure 1
Histologic features and diagnostic criteria of aggressive types and variants of differentiated thyroid carcinoma, including poorly differentiated carcinoma (PDTC), papillary thyroid carcinoma (PTC) tall cell variant, columnar cell variant, and hobnail variant. The diagnostic features of each tumor are listed in the textbox below. HPFs: high power fields. Blue arrows: mitoses. Magnification: 100×.
Figure 2
Figure 2
Capsular invasion. Upper panels: capsular invasion is defined as complete transgression of the capsule or satellite nodule(s) lying outside of the tumor capsule. Lower panels: incomplete capsular invasion is defined as incomplete penetration of the tumor capsule. Black lines outline the outer contour of tumor capsule. S: satellite nodule. Magnification: 40×.
Figure 3
Figure 3
Lymphovascular invasion (LVI). LVI is defined as an intravascular tumor attached to the vessel wall or associated with fibrin thrombi. Blue arrowheads: endothelial cells. Black arrows: fibrin thrombus. Magnification: 200×.
Figure 4
Figure 4
Extrathyroidal extension (ETE). Microscopic ETE does not affect American Joint Committee on Cancer (AJCC) pT staging, whereas gross ETE into strap muscle or adjacent organs is considered AJCC pT3b and pT4a, respectively. Magnification of microscopic picture: 40×.
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