Three-dimensional cytomorphology and its relationship with clinical stage in fine needle aspiration biopsy of papillary thyroid carcinoma

OBJECTIVE: To elucidate three-dimensional (3-D) cytomorphology and its rela tionship with clinical stage in fine needle aspiration biopsy (FNAB) of pap illary thyroid carcinomas (PTC). STUDY DESIGN: FNAB was performed in tumors from 34 patients with PTC. The a spirate was stained and observed under a light microscope (LM). The aspirat e was also fixed, dehydrated, critical point dried, spattered with gold ion s and observed with a scanning electron microscope (SEM). Findings under SE M were correlated with the presentation tinder LM and also with clinical st age. As a control, FNAB was also performed on a normal part of the thyroid in six patients. RESULTS: Under SEM, normal thyroid cells appeared as round, scattered cells or sheets with a uniform honey-comb cellular arrangement. In PTC, cell she ets with uniform nuclear morphology under LM usually showed a uniform cell arrangement and with distinct cell borders under SEM. Cell sheets with nucl ear pleomorphism tinder LM usually showed a more-disorganized arrangement a nd with indistinct cell borders under SEM. PTC at advanced clinical stages usually presented with a disorganised cell arrangement, indistinct cell bor ders and loss of microvilli. CONCLUSION: 3-D cytomorphology in FNAB of PTC was related to clinical stage and might be a prognostic factor for PTC.