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Indian Journal of Pathology and Oncology


To evaluate the role of cellular swirls in fine needle aspiration cytology diagnosis of papillary carcinoma thyroid


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Author Details: Binay Kumar, Usha Joshi, Priyansh Srivastav, Harsh Khetan

Volume : 4

Issue : 1

Online ISSN : 2394-6792

Print ISSN : 2394-6784

Article First Page : 18

Article End Page : 22


Abstract

Objective: To enhance the diagnostic accuracy of papillary carcinoma thyroid by evaluating nuclear and architectural features on cytology with address about the details of cytologic pitfalls.
Study Design: 14 cases of papillary carcinoma thyroid diagnosed on FNA cytology, which were confirmed on histology, during last five years, were reviewed, retrospectively, using Papanicolaou stained and May Grunwald Geimsa stained slides for following parameters-
Architecture: Papillary pattern, swirling pattern, follicular pattern, sheets. Nuclear features: nuclear inclusion, nuclear grooving, and powdery chromatin. Others: metaplastic cells, chewing gum colloid, cystic macrophage, multinucleated giant cells.
Result: Out of the various features evaluated the most consistent findings were papillary and swirling pattern; nuclear inclusion and nuclear grooving and metaplastic cells.In our study, on an average intranuclear grooves were present in 30-40% of the follicular epithelial cells except in one case where it was 80-90%. The average of intranuclear pseudoinclusions was 3-5% in all cases except one where it was 32%. Other findings were multinucleated giant cells, cystic macrophages, chewing gum colloid.
Conclusion: Diagnosis of papillary carcinoma thyroid can be made accurately if architectural features (papillary or swirling pattern, nuclear features (nuclear inclusions and grooves) and metaplastic cells are present together in a thyroid aspirate. Among architectural features swirling pattern is consistent finding in our study which could be included among diagnostic criteria.

Keywords:
FNAC Thyroid; Papillary Carcinoma; Swirling Pattern