图片1、 Cribriform-morular variant of papillary thyroid carcinoma.The cribriform-morular variant of PTC has unique histologic features and is associated with familial adenomatous polyposis (FAP) and germline APC mutations. Although sporadic cases of cribriform-morular PTC occur, this variant often occurs in FAP, an autosomal dominant syndrome of gastrointestinal adenomas and carcinomas,endometrial cancer, and medulloblastomas. Patients with FAP may present with the cribriform-morular variant of PTC ; thus, patients diagnosed with cribriform-morular PTC should be evaluated for FAP.

图片2、Cribriform-morular variant of papillary thyroid carcinoma.The cribriform areas in the cribriform-morular variant of PTC have arches and anastomosing bars of cells. The arches and bars of cells lack intervening fibrovascular stroma. These tumors have cytologic features of PTC, and areas of follicular and papillary growth may be seen.The architectural features are the most distinguishing in separating cribriform-morular PTC from other types of PTC. These tumors occur most commonly in women, they may be single or multifocal, and their prognosis is similar to that of classic PTC.

图片3、Cribriform-morular variant of papillary thyroid carcinoma.Shown is an area of prominent morules in a cribriform-morular PTC.The morules are composed of spindle/oval tumor cells, which are positive for TTF1 and sometimes thyroglobulin. The tumor cells show aberrant nuclear and cytoplasmic expression of β-catenin. The morular areas may show absent or focal keratin expression. Nuclear expression of estrogen and progesterone receptors and Bcl-2 also has been reported.

图片4、Cribriform-morular variant of papillary thyroid carcinoma.High-power view of morules in the cribriform-morular variant of PTC.The morules are a helpful diagnostic feature but must be distinguished from those of squamous metaplasia. Unlike in squamous metaplasia, the morules may lack or show decreased staining for keratin.

图片5、Cribriform-morular variant of papillary thyroid carcinoma.Aberrant nuclear and cytoplasmic staining for β-catenin is present in cribriform-morular PTC. The follicular cells in the surrounding thyroid may show membranous staining for β-catenin, but aberrant cytoplasmic and nuclear staining for β-catenin is seen in cribriform-morular PTC .

图片6、Cribriform-morular variant of papillary thyroid carcinoma.Cribriform-morular variant of PTC shows nuclear staining for TTF1 .

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