Digital case
JRC:1331 : Poorly differentiated (insular) carcinoma (F; 34 y/o)
JRC:2667 : Poorly differentiated (insular) carcinoma (F; 67 y/o)
JRC:15038 : Poorly differentiated (insular) carcinoma (Vs very florid hyperplasia with papillae).
Definition: The insular carcinoma is a poorly differentiated follicular carcinoma.
Microscopy
Histologically, it consists of well-defined nests of fairly uniform cells and small follicles. These cells often show prominent mitotic activity and the tumour is infiltrative and aggressive in behaviour.
Cytology
Cytologically, smears are hypercellular with sheets of cells, occasional microfollicular aggregates and dispersed cells.
The sheets of cells typically show nuclear crowding.
The cells are relatively uniform with no gross pleomorphism.
Intracytoplasmic vacuoles containing thyroglobulin may be seen. Necrosis may be present. The nuclear to cytoplasmic ratio is high with mild to moderate anisokaryosis and nuclear atypia.
Intranuclear inclusions and nuclear grooving can be seen together with a papillary configuration to some of the cell groups and this can cause confusion with papillary carcinoma.
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