Abstract
The terminology and definitions pertaining to thyroid malignancies of follicular cell origin that are neither well-differentiated papillary or follicular carcinomas nor undifferentiated anaplastic carcinomas remain controversial. Against this background, we previously proposed that “poorly differentiated carcinoma” should be added to the classification of thyroid carcinoma arising from follicular epithelium. The histological criteria and biological characteristics of poorly differentiated carcinoma of the thyroid were described. In this discussion, we make a new proposal concerning the histological classification of thyroid cancers derived from follicular epithelium. According to this proposal, thyroid cancers can be divided into common types and special types. In the common types, the usual histology should be included. The common types are well-differentiated carcinoma, poorly differentiated carcinoma, and undifferentiated carcinoma. The specific types include columnar-cell carcinoma, tall cell carcinoma, cribriform carcinoma, and other rare carcinomas.
Similar content being viewed by others
References
Donohue JH, Goldfien SD, Miller TR. Do the prognoses of papillary and follicular carcinomas differ? Am J Surg 148:168–173, 1984.
Franssila KO. Is the differentiation between papillary and follicular thyroid carcinoma valid? Cancer 32:853–864, 1973.
Sakamoto A, Kasai N, Sugano H. Poorly differentiated carcinoma of the thyroid. A clinicopathologic entity for a high-risk group of papillary and follicular carcinomas. Cancer 52:1849–1855, 1983.
Dobashi Y, Sakamoto A, Sugimura H, et al. Overexpression of p53 as a possible prognostic factor in human thyroid carcinomas. Am J Surg Pathol 17:375–381, 1993.
Dobashi Y, Sugimura H, Sakamoto A, et al. Stepwise participation of p53 gene mutation during dedifferentiation of human thyroid carcinomas. Diagn Mol Pathol 3:1–14, 1994.
Nishida T, Katayama S, Tsujimoto M, Nakamura J, Matsuda H. Clinicopathological significance of poorly differentiated thyroid carcinoma. Am J Surg Pathol 23:205–211, 1999.
Byar DP, Green SB, Dor P. A prognostic index for thyroid carcinoma: a study of the EORTC Thyroid Cancer CO-operative Group. Eur J Cancer 15:1033–1041, 1979.
Carcangiu ML, Zampi G, Rosai J. Poorly differentiated (insular) thyroid carcinoma: a reinterpretation of Langerhans’ “wuchende Struma.” Am J Surg Pathol 8:665–668, 1984.
Evans HL. Columnar-cell carcinoma of the thyroid. A report of two cases of an aggressive variant of thyroid carcinoma. Am J Clin Pathol 85:77–80, 1986.
Johnson TL, Lloyd RV, Thompson NW, Beierwaltes WH, Sisson JC. Prognostic implications of the tall cell variant of papillary thyroid carcinoma. Am J Surg Pathol 12:22–27, 1988.
Sasaki A, Daa T, Kashima K, Yokoyama S, Nakayama I, Noguchi S. Insular component as a risk factor of thyroid carcinoma. Pathol Int. 46:939–946, 1996.
Sobrinho-Simoes M, Nesland JM, Johannessen JV. Columnar-cell carcinoma. Another variant of poorly differentiated carcinoma of the thyroid. Am J Clin Pathol 89:264–267, 1998.
Yamamoto Y, Izumi K, Otsuka H. An immuno-histochemical study of epithelial membrane antigen, cytokeratin and vimentinin papillary thyroid carcinoma. Recognition of lethal and favorable prognostic types. Cancer 70:2326–2333, 1992.
Donghi R, Longoni A, Pilotti S, Michieli P, Della Porta G, Pierotti MA. p53 mutations are restricted to poorly differentiated and undifferentiated carcinomas of the thyroid gland. J Clin Invest 91:1753–1760, 1993.
Fagin JA, Matsuo K, Kamakar A, Chen DL, Tang SH, Koeffler HP. High prevalence of mutations of the p53 gene in poorly differentiated human thyroid carcinomas. J Clin Invest 91:179–184, 1993.
Ivanova R, Soares P, Castro P, Sobrinho-Simoes M. Diffuse (or multinodular) for follicular variant of papillary thyroid carcinoma: a clinicopathologic and immunohistochemical analysis of ten cases of an aggressive form of differentiated thyroid carcinoma. Virchows Arch 440:418–424, 2002.
Pilotti S, Collini P, Del Bo R, Cattoretti G, Pierotti MA, Filke F. A novel panel of antibodies that segregates immunocytochemically poorly differentiated carcinoma from undifferentiated carcinomas originating from the follicular epithelium of the thyroid gland. J Pathol 172:337–342, 1994.
Nikiforov YE, Erickson LA, Nikiforova MN, Caudill CM, Lloyd RV. Solid variant of papillary thyroid carcinoma: incidence, clinical-pathologic characteristics, molecular analysis, and biologic behavior. Am J Surg Pathol 25:1478–1484, 2001.
Nikiforava MN, Kimura ET, Gandhi M, et al. BRAF mutations in thyroid tumors are restricted to papillary carcinomas and anaplastic or poorly differentiated carcinomas arising from papillary carcinomas. Clin Endocrinol Metab 88:5399–5404, 2003.
Harach HR, Franssila KO. Thyroglobulin immunostaining in follicular thyroid carcinoma; relationship to the degree of differentiation and cell type. Histopathology 13:43–54, 1998.
Oyama T, Suzuki T, Hara F, et al. N-ras mutation of thyroid tumor with special reference to follicular type. Pathol Int 45:45–50, 1995.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sakamoto, A. Definition of poorly differentiated carcinoma of the thyroid: The Japanese experience. Endocr Pathol 15, 307–311 (2004). https://doi.org/10.1385/EP:15:4:307
Issue Date:
DOI: https://doi.org/10.1385/EP:15:4:307