AUTHOR=Zhang Yongyue , Mei Fang , He Xiaoxi , Ma Jing , Wang Shumin 

TITLE=Reconceptualize tall-cell variant papillary thyroid microcarcinoma: From a “sonographic histology” perspective

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.1001477

DOI=10.3389/fendo.2022.1001477

ISSN=1664-2392

ABSTRACT=Objective: To explore the relationship between sonographic features and histological manifestations in tall cell variant (TCV)-papillary thyroid microcarcinoma (PTMC), thus to propose the concept of “Sonographic Histology” and explore the value of it in clinical management of aggressive TCV.
Methods: This study retrospectively included 104 participants who were admitted to Peking University Third Hospital from 2015 to 2022 and were histopathologically confirmed as TCV-PTMC or classical-PTMC. We mainly compared the general situation, sonographic characteristics, and pathological specimens in the two cohorts.
Results: Hypoechoic nodules with localized central isoechoic lesion and hypoechoic halo around nodules are most often seen in TCV-PTMCs, which correlates with circumferentially distributed tumor epithelialum and densely distributed tumor stroma histopathologically. Besides, TCV-PTMCs demonstrated nodules with more regular margin and less microcalcification than classical-PTMCs, which leads to an underestimation of the risk of TCV-microcarcinomas. 
Conclusion: The excellent correspondence between ultrasound echo pattern and tissue cell arrangement is defined as “Sonographic Histology” in this study and applied in preoperative identification of TCV-PTMC. We suggest this concept may provide novel insights for the identification of special subtypes thyroid tumor and modify pitfalls of thyroid imaging reporting and data system (TI-RADS) in aggressive variants microcarcinoma.