Skip to main content

Poorly Differentiated Thyroid Carcinoma

  • Chapter
  • First Online:
The Bethesda System for Reporting Thyroid Cytopathology

Abstract

Poorly differentiated thyroid carcinoma (PDTC) was first proposed as a distinct subtype of thyroid malignancy by Carcangiu et al. These authors reinterpreted the original observation made in 1907 by Langhans, who described a locally aggressive tumor with a peculiar architecture: tumor cells arranged in large, round to oval formations, the so-called “insulae.” Currently, there are 2 recognized subtypes of PDTC - insular and non-insular. PDTC is a rare malignancy, accounting for 4–7% of all thyroid cancers. It has an aggressive clinical behavior intermediate between that of the well differentiated thyroid carcinomas (papillary carcinoma, follicular carcinoma, and Hürthle cell carcinoma) and undifferentiated (anaplastic) thyroid carcinoma. PDTCs often present at an advanced stage, have a propensity for local recurrence, and tend to metastasize to regional lymph nodes, lung, and bones. The mean 5-year survival of patients with PDTC is approximately 50%. Well differentiated thyroid carcinomas with a focal (10% or greater) PDTC component follow a more aggressive clinical course than standard well differentiated carcinomas of the thyroid.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 29.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Carcangiu ML, Zampi G, Rosai J. Poorly differentiated (“insular”) thyroid carcinoma. A reinterpretation of Langhans’ “wuchernde struma”. Am J Surg Pathol 1984;8(9):655-668.

    Google Scholar 

  2. Langhans T. Uber die epithelialen formen der malignen struma. Virchows Arch (A). 1907;189:69-188.

    Google Scholar 

  3. Sobrinho Simoes M, Albores-Saavedra J, Tallini G, et al. Poorly differentiated carcinoma. In: DeLellis R, Lloyd RV, Heitz PU, Eng C, eds. World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of Endocrine Organs. Lyon: IARC Press 2004.

    Google Scholar 

  4. Volante M, Landolfi S, Chiusa L, et al. Poorly differentiated carcinomas of the thyroid with trabecular, insular, and solid patterns: a clinicopathologic study of 183 patients. Cancer. 2004;100(5):950-957.

    Article  PubMed  Google Scholar 

  5. Decaussin M, Bernard MH, Adeleine P, et al. Thyroid carcinomas with distant metastases: a review of 111 cases with emphasis on the prognostic significance of an insular component. Am J Surg Pathol. 2002;26(8):1007-1015.

    Article  PubMed  Google Scholar 

  6. Bedrossian CWM, Martinez F, Silverberg AB. Fine needle aspiration. In: Gnepp DR, ed. Pathology of the head and neck. New York: Churchill Livingstone; 1988:25-99.

    Google Scholar 

  7. Flynn SD, Forman BH, Stewart AF, et al. Poorly differentiated (“insular”) carcinoma of the thyroid gland: an aggressive subset of differentiated thyroid neoplasms. Surgery. 1988;104(6):963-970.

    CAS  PubMed  Google Scholar 

  8. Pietribiasi F, Sapino A, Papotti M, et al. Cytologic features of poorly differentiated ‘insular’ carcinoma of the thyroid, as revealed by fine-needle aspiration biopsy. Am J Clin Pathol. 1990;94:687-692.

    CAS  PubMed  Google Scholar 

  9. Sironi M, Collini P, Cantaboni A. Fine needle aspiration cytology of insular thyroid carcinoma: a report of four cases. Acta Cytol. 1992;36:435-439.

    CAS  PubMed  Google Scholar 

  10. Guiter GE, Auger M, Ali SZ, et al. Cytopathology of insular carcinoma of the thyroid. Cancer (Cancer Cytopathol). 1999;87:196-202.

    CAS  Google Scholar 

  11. Nguyen GK, Akin M-RM. Cytopathology of insular carcinoma of the thyroid. Diagn Cytopathol. 2001;25:325-330.

    Article  CAS  PubMed  Google Scholar 

  12. Oertel YC, Miyahara-Felipe L. Cytologic features of insular carcinoma of the thyroid: a case report. Diagn Cytopathol. 2006;34(8):572-575.

    Article  PubMed  Google Scholar 

  13. Zakowski MF, Schlesinger K, Mizrachi HH. Cytologic features of poorly differentiated “insular” carcinoma of the thyroid. A case report. Acta Cytol 1992;36(4):523-526.

    Google Scholar 

  14. Bongiovanni M, Bloom L, Krane JF, et al. Cytomorphologic features of poorly differentiated thyroid carcinoma. A multi-institutional analysis of 40 cases. Cancer (Cancer Cytopathol) 2009;117(3):185-194.

    Google Scholar 

  15. Sanders EM Jr, LiVolsi VA, Brierley J, et al. An evidence-based review of poorly differentiated thyroid cancer. World J Surg. 2007;31(5):934-945.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Bongiovanni, M., Faquin, W.C. (2010). Poorly Differentiated Thyroid Carcinoma. In: Ali, S., Cibas, E. (eds) The Bethesda System for Reporting Thyroid Cytopathology. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-87666-5_10

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-87666-5_10

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-387-87665-8

  • Online ISBN: 978-0-387-87666-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics