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High-Grade Follicular Cell-Derived Non-Anaplastic Thyroid Carcinoma

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The Bethesda System for Reporting Thyroid Cytopathology

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Abstract

High-grade follicular cell-derived non-anaplastic thyroid carcinoma (HGFDTC) comprises poorly differentiated thyroid carcinomas (PDTC) and differentiated high-grade thyroid carcinomas (DHGTC). These are rare malignancies, accounting for 1–6.7% of all thyroid cancers. The age at presentation is between 18 and 63 years, with a slight female predilection. They have an aggressive clinical behavior intermediate between that of the well differentiated thyroid carcinomas and undifferentiated (anaplastic) thyroid carcinoma. Histologically, the hallmark of HGFDTC is the presence of high mitotic activity and tumor necrosis in a thyroid carcinoma of follicular cell origin characterized by a papillary and/or follicular growth pattern (for DHGTC) or by an insular, solid, or trabecular growth pattern (for PDTC). Cytologically, DHGTC shows classic papillary or follicular architecture associated with necrosis or mitosis, while PDTCs are difficult to recognize because their cytomorphologic features overlap with those of follicular neoplasms. Immunostains for keratins and thyroid markers (thyroglobulin, TTF-1, and PAX8) are usually expressed in the tumor cells. BRAF V600E, RAS, and TERT promoter are frequently mutated. Because of its poor clinical prognosis, HGFDTC is managed more aggressively than well differentiated thyroid carcinomas.

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Acknowledgment

The authors would like to acknowledge the work in earlier editions of this chapter of Drs. Guido Fadda and William Faquin.

Author information

Authors and Affiliations

  1. Synlab Pathology SA, Lausanne, Switzerland

    Massimo Bongiovanni

  2. Department of Pathology and Laboratory Medicine, University of Kentucky College of Medicine, Lexington, KY, USA

    Derek Allison

  3. Department of Pathology, University of Michigan, Ann Arbor, MI, USA

    Madelyn Lew

  4. Department of Pathology, Cochin Hospital, Paris, France

    Beatrix Cochand-Priollet

Authors
  1. Massimo Bongiovanni
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  2. Derek Allison
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  3. Madelyn Lew
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  4. Beatrix Cochand-Priollet
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Corresponding author

Correspondence to Massimo Bongiovanni .

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Editors and Affiliations

  1. Department of Pathology, The Johns Hopkins Hospital/The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Syed Z. Ali

  2. Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Paul A. VanderLaan

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Bongiovanni, M., Allison, D., Lew, M., Cochand-Priollet, B. (2023). High-Grade Follicular Cell-Derived Non-Anaplastic Thyroid Carcinoma. In: Ali, S.Z., VanderLaan, P.A. (eds) The Bethesda System for Reporting Thyroid Cytopathology. Springer, Cham. https://doi.org/10.1007/978-3-031-28046-7_10

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  • DOI: https://doi.org/10.1007/978-3-031-28046-7_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-28045-0

  • Online ISBN: 978-3-031-28046-7

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