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Thyroid FNA Cytology pp 241–248Cite as

Hobnail Variant of Papillary Thyroid Carcinoma

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Abstract

Hobnail variant of papillary thyroid carcinoma (HV-PTC) has recently been described as a rare variant of moderately differentiated PTC, with an aggressive behavior and relatively poor prognosis. More than 100 cases have been described to date. HV-PTC is microscopically characterized by a predominantly micropapillary growth pattern and hobnail appearance of cells due to apically placed bulging nuclei. A diagnosis of hobnail variant HV-PTC requires at least 30% of cells in a tumor to exhibit a hobnail-micropapillary pattern, although minor hobnail-micropapillary features are of significance and should be noted in a pathology report. Cytologic preparations of HV-PTC display micropapillary structures, loss of polarity, discohesiveness, and hobnail cells with teardrop appearance and soap bubble-like pseudo-nuclear inclusions. All these findings provide a clue for preoperative diagnosis of HPTC, which may help to render a decision regarding the adequate extent of a thyroidectomy. Compared to patients with classic PTC, patients with HV-PTC frequently have extrathyroidal extensions, exhibit nodal or distant metastasis, and respond poorly to radioiodine treatment—factors which contribute to increased deaths among this group. Our chapter illustrated by a case of HV-PTC provides a comprehensive and contemporary review of this entity, with a special emphasis on surgical pathology, cytopathology, immunohistochemistry, and differential diagnosis.

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Author information

Authors and Affiliations

  1. Faculty of Medicine, Department of Pathology, Chulalongkorn University, Bangkok, Thailand

    Andrey Bychkov

  2. Department of Pathology, Kameda Medical Center, Kamogawa, Chiba, Japan

    Andrey Bychkov

  3. Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Chan Kwon Jung

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  1. Andrey Bychkov
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Correspondence to Andrey Bychkov .

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Editors and Affiliations

  1. Faculty of Medicine, Nara Hospital, Kindai University, Ikoma, Japan

    Kennichi Kakudo

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Bychkov, A., Jung, C.K. (2019). Hobnail Variant of Papillary Thyroid Carcinoma. In: Kakudo, K. (eds) Thyroid FNA Cytology. Springer, Singapore. https://doi.org/10.1007/978-981-13-1897-9_30

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  • DOI: https://doi.org/10.1007/978-981-13-1897-9_30

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  • Publisher Name: Springer, Singapore

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  • Online ISBN: 978-981-13-1897-9

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