Poorly differentiated thyroid carcinoma: The Turin proposal for the use of uniform diagnostic criteria and an algorithmic diagnostic approach

Marco Volante, Paola Collini, Yuri E. Nikiforov, Atsuhiko Sakamoto, Kennichi Kakudo, Ryohei Katoh, Ricardo V. Lloyd, Virginia A. LiVolsi, Mauro Papotti, Manuel Sobrinho-Simoes, Gianni Bussolati, Juan Rosai

Research output: Contribution to journalArticle

Abstract

Poorly differentiated (PD) thyroid carcinomas lie both morphologically and behaviorally between well-differentiated and undifferentiated (anaplastic) carcinomas. Following the original description of this entity, different diagnostic criteria have been employed, resulting in wide discrepancies and confusion among pathologists and clinicians worldwide. To compare lesions occurring in different geographic areas and the diagnostic criteria applied in those countries, we designed a study with a panel of internationally recognized thyroid pathologists to develop consensus diagnostic criteria for PD carcinomas. Eighty-three cases were collected from Europe, Japan, and the United States, and circulated among 12 thyroid pathologists. Diagnoses were made without any knowledge of the clinical parameters, which were subsequently used for survival analysis. A consensus meeting was then held in Turin, Italy, where an agreement was reached concerning the diagnostic criteria for PD carcinoma. These include (1) presence of a solid/trabecular/insular pattern of growth, (2) absence of the conventional nuclear features of papillary carcinoma, and (3) presence of at least one of the following features: convoluted nuclei; mitotic activity ≥3×10 HPF; and tumor necrosis. An algorithmic approach was devised for practical use in the diagnosis of this tumor.

Original languageEnglish
Pages (from-to)1256-1264
Number of pages9
JournalAmerican Journal of Surgical Pathology
Volume31
Issue number8
DOIs
Publication statusPublished - Aug 2007

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Keywords

  • Carcinoma
  • Classification
  • Poorly differentiated
  • Prognosis
  • Thyroid

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Volante, M., Collini, P., Nikiforov, Y. E., Sakamoto, A., Kakudo, K., Katoh, R., Lloyd, R. V., LiVolsi, V. A., Papotti, M., Sobrinho-Simoes, M., Bussolati, G., & Rosai, J. (2007). Poorly differentiated thyroid carcinoma: The Turin proposal for the use of uniform diagnostic criteria and an algorithmic diagnostic approach. American Journal of Surgical Pathology, 31(8), 1256-1264. https://doi.org/10.1097/PAS.0b013e3180309e6a