Three-Dimensional Cytomorphology and Its Relationship with Clinical Stage in Fine Needle Aspiration Biopsy of Papillary Thyroid Carcinoma

Abstract

To elucidate three-dimensional (3-D) cytomorphology and its relationship with clinical stage in fine needle aspiration biopsy (FNAB) of papillary thyroid carcinoma (PTC). FNAB was performed in tumors from 34 patients with PTC. The aspirate was stained and observed under a light microscope (LM). The aspirate was also fixed, dehydrated, critical point dried, spattered with gold ions and observed with a scanning electron microscope (SEM). Findings under SEM were correlated with the presentation under LM and also with clinical stage. As a control, FNAB was also performed on a normal part of the thyroid in six patients. Under SEM, normal thyroid cells appeared as round, scattered cells or sheets with a uniform honeycomb cellular arrangement. In PTC, cell sheets with uniform nuclear morphology under LM usually showed a uniform cell arrangement and with distinct cell borders under SEM. Cell sheets with nuclear pleomorphism under LM usually showed a more-disorganized arrangement and with indistinct cell borders under SEM. PTC at advanced clinical stages usually presented with a disorganized cell arrangement, indistinct cell borders and loss of microvilli. 3-D cytomorphology in FNAB of PTC was related to clinical stage and might be a prognostic factor for PTC.