Papillary carcinomas - Figure 16. Differential diagnostics: cystically degenerated papillary carcinoma or benign lesion.

The greatest issue in the diagnosis of papillary carcinoma is gaining adequate material in cystic lesions. Even in cases when the smear contains reliable number of cells, the diagnosis may be more difficult because of degenerative changes of follicular cells. The presence of nuclear crowding is one of the most important sign in such cases.
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Benign nodular hyperplasia- case 16

Papillary carcinoma - case 27


Our diagnosis was suspicion of papillary carcinoma on the presence of grooves. Note the regular arrangement of follicular cells.


Our diagnosis was suspicion of papillary carcinoma on the presence of nuclear crowding and grooves.

Benign nodular hyperplasia- case 25

Papillary carcinoma - case 40


Follicular cells occur in regular monolayered sheets.


The presence of one or two inclusions has only limited significance in the case of a highly degenerated lesion. On the other hand, the disarranged structure of cells was the sign which raised the possibility of papillary cancer.

Chronic lymphocytic thyroiditis- case 20

Oxyphilic variant of papillary carcinoma - case 70


Although the presence of grooves is not a reassuring phenomenon, the lack of tendency of cells to dissociate stands against the possibility of a tumor.


The tendency of cells to dissociate is the most important sign favouring a tumor.