Histology Course A IV 48 Department of Pathology, University of Zurich Histokurs

A IV 48 papillary carcinoma of the thyroid, lymph node metastasis IHC: Tg further information (German) on HiPaKu 
  ICD-10: C 73.9, C77.0; ICD-O: 8260/3, 8260/6
38-year-old female exhibits painless cervical lymph node swelling. An enlarged lymph node is excised.
- The architecture of the lymph node is destroyed by a cystic tumor, which infiltrates the capsule. At the periphery remnants of lymphatic tissue are present.
- Individual cysts contain papillary tumor formations consisting of delicate fibrovascular cores and a lining of cuboidal to cylindrical cells.
- The nuclei of the tumor cells are enlarged exhibit an oval shape and display the following characteristics: (1) nuclear clearing or ground-glass appearance; (2) nuclear grooves; (3) nuclear inclusions; (4) overlapping. These nuclear features not the presence of papillae allow the diagnosis of a papillary thyroid carcinoma.
- Immunohistochemical staining shows presence of thyreoglobulin in the cytoplasm of a substantial number of tumor cells.

The prognosis of papillary cancer of the thyroid is excellent. These tumors typically spread lymphatically. Even in the presence of lymph node metastasis they exhibit a 15-years-survival rate of 80 - 90%.