Verification of anaplastic thyroid carcinoma: a comprehensive analysis of the limitations of current methods
DOI:
https://doi.org/10.24866/3033-5485/2025-3/38-49Keywords:
anaplastic thyroid carcinoma, immunohistochemistry, core needle biopsy, fine-needle aspiration biopsy, diagnosis, non-diagnostic specimenAbstract
Anaplastic thyroid carcinoma is one of the most aggressive malignant neoplasms, characterized by an extremely poor prognosis and requiring prompt diagnostic verification to initiate an optimal therapeutic approach. The catastrophic prognosis is due to a unique combination of biological aggressiveness, resistance to therapy, and diagnostic challenges associated with the morphological heterogeneity of the tumor. The present study demonstrates significant limitations of conventional cytological diagnostic methods, including fine-needle aspiration biopsy, in the verification of this pathology, which are attributable to the characteristic morphological features of the tumor tissue.
References
Ragazzi M., Ciarrocchi A., Sancisi V., Gandolfi G., Bisagni A., Piana S. Update on anaplastic thyroid carcinoma: morphological, molecular, and genetic features of the most aggressive thyroid cancer. International Journal of Endocrinology, 2014, vol. 2014. DOI: https://doi.org/10.1155/2014/790834
Podany P., Abi-Raad R., Barbieri A., Garritano J., Prasad M.L., Cai G., Adeniran A.J., Gilani S.M. Anaplastic thyroid carcinoma: cytomorphologic features on fine-needle aspiration and associated diagnostic challenges. American Journal of Clinical Pathology, 2022, vol. 157, no. 4, pp. 608–619. DOI: https://doi.org/10.1093/ajcp/aqab159
Haugen B.R., Alexander E.K., Bible K.C., Doherty G.M., Mandel S.J., Nikiforov Y.E., Pacini F., Randolph G.W., Sawka A.M., Schlumberger M., Schuff K.G., Sherman S.I., Sosa J.A., Steward D.L., Tuttle R.M., Wartofsky L. American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid: Official Journal of the American Thyroid Association, 2016, vol. 26, no. 1, pp. 1–133. DOI: https://doi.org/10.1089/thy.2015.0020
Us-Krasovec M., Golouh R., Auersperg M., Besic N., Ruparcic-Oblak L. Anaplastic thyroid carcinoma in fine needle aspirates. Acta Cytologica, 1996, vol. 40, no. 5, pp. 953–958. DOI: https://doi.org/10.1159/000334007
Baloch Z., Mete O., Asa S.L. Immunohistochemical biomarkers in thyroid pathology. Endocrine Pathology, 2016, vol. 29, no. 2, pp. 91–112. DOI: https://doi.org/10.1007/s12022-018-9532-9
Talbott I., Wakely P.E. Undifferentiated (anaplastic) thyroid carcinoma: Practical immunohistochemistry and cytologic look-alikes. Seminars in Diagnostic Pathology, 2015, vol. 32, no. 4, pp. 305–310. DOI: https://doi.org/10.1053/j.semdp.2014.12.012
Smallridge R.C., Marlow L.A., Copland J.A. Anaplastic thyroid cancer: molecular pathogenesis and emerging therapies. Endocrine-Related Cancer, 2009, vol. 16, no. 1, pp. 17–44. DOI: https://doi.org/10.1677/ERC-08-0154
Zhu Y., Song Y., Xu G., Fan Z., Ren W. Causes of misdiagnoses by thyroid fine-needle aspiration cytology (FNAC): our experience and a systematic review. Diagnostic Pathology, 2020, vol. 15, art. 1. DOI: https://doi.org/10.1186/s13000-019-0924-z
Suh H.J., Moon H.J., Kwak J.Y., Choi J.S., Kim E.K. Anaplastic thyroid cancer: ultrasonographic findings and the role of ultrasonography-guided fine needle aspiration biopsy. Yonsei Medical Journal, 2013, vol. 54, no. 6, pp. 1400–1406. DOI: https://doi.org/10.3349/ymj.2013.54.6.1400
Vander Poorten V., Goedseels N., Triantafyllou A., Sanabria A., Clement P.M., Cohen O., Golusinski P., Guntinas-Lichius O., Piazza C., Randolph G.W., Rinaldo A., Ronen O., Cabanillas M.E., Shaha A.R., Teng Y., Tufano R.P., Williams M.D., Zafereo M., Ferlito A. Effectiveness of core needle biopsy in the diagnosis of thyroid lymphoma and anaplastic thyroid carcinoma: A systematic review and meta-analysis. Frontiers in Endocrinology, 2022, vol. 13. DOI: https://doi.org/10.3389/fendo.2022.971249
Bakuła-Zalewska E. B., Kwapisz M.I., Góralski P., Długosińska J., Gałczyński J., Dedecjus M. Core needle biopsy: an efficacious adjunct to cytological diagnosis in thyroid tumours suspected of anaplastic carcinoma – single-centre experience. Contemporary Oncology, 2024, vol. 28, no. 2, pp. 167–171. DOI: https://doi.org/10.5114/wo.2024.142468
Sung J.Y., Na D.G., Kim K.S., Yoo H., Lee H., Kim J.H., Baek J.H. Diagnostic accuracy of fine-needle aspiration versus core-needle biopsy for the diagnosis of thyroid malignancy in a clinical cohort. European Radiology, 2012, vol. 22, no. 7, pp. 1564–1572. DOI: https://doi.org/10.1007/s00330-012-2405-6
Trimboli P., Giovanella L. Reliability of core needle biopsy as a second-line procedure in thyroid nodules with an indeterminate fine-needle aspiration report: a systematic review and meta-analysis. Ultrasonography, 2018, vol. 37, no. 2, pp. 121–128. DOI: https://doi.org/10.14366/usg.17066
Wolinski K., Stangierski A., Ruchala M. Comparison of diagnostic yield of core-needle and fine-needle aspiration biopsies of thyroid lesions: Systematic review and meta-analysis. European Radiology, 2017, vol. 27, no. 1, pp. 431–436. DOI: https://doi.org/10.1007/s00330-016-4356-9
Wong K.S., Barletta J.A. Thyroid tumors you don't want to miss. Surgical Pathology Clinics, 2019, vol. 12, no. 4, pp. 901–919. DOI: https://doi.org/10.1016/j.path.2019.08.008
Liu H., Lin F. Application of immunohistochemistry in thyroid pathology. Archives of Pathology & Laboratory Medicine, 2015, vol. 139, no. 1, pp. 67–82. DOI: https://doi.org/10.5858/arpa.2014-0056-RA
Alhejaily A.G., Alhuzim O., Alwelaie Y. Anaplastic thyroid cancer: Pathogenesis, prognostic factors and genetic landscape (Review). Molecular and Clinical Oncology, 2023, vol. 19, no. 6. DOI: https://doi.org/10.3892/mco.2023.2695
Elia G., Patrizio A., Ragusa F., Paparo S.R., Mazzi V., Balestri, E., Botrini C., Rugani L., Benvenga S., Materazzi G., Spinelli C., Antonelli A., Fallahi P., Ferrari S.M. Molecular features of aggressive thyroid cancer. Frontiers in Oncology, 2022, vol. 12. DOI: https://doi.org/10.3389/fonc.2022.1099280
Volante M., Lam A.K., Papotti M., Tallini G. Molecular pathology of poorly differentiated and anaplastic thyroid cancer: What do pathologists need to know? Endocrine Pathology, 2021, vol. 32, no. 1, pp. 63–76. DOI: https://doi.org/10.1007/s12022-021-09665-2
Zeyghami W., Hansen M.U., Jakobsen K.K., Groenhøj C., Feldt-Rasmussen U., von Buchwald C., Hahn C.H. Liquid biopsies in thyroid cancers: a systematic review and meta-analysis. Endocrine-related Cancer, 2023, vol. 30, no. 12. DOI: https://doi.org/10.1530/ERC-23-0002
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Артур Альбертович Мустафаев, Роман Анатольевич Гончарук, Регина Анатольевна Думбрава, Евгения Владимировна Хамуева

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.