Thyroid gland
Papillary carcinoma
Tall cell variant

Author: Shahidul Islam, M.D., Ph.D. (see Authors page)

Revised: 26 October 2016, last major update March 2009

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed Search: Tall cell variant

Cite this page: Tall cell variant. PathologyOutlines.com website. http://pathologyoutlines.com/topic/thyroidtallcellvariant.html. Accessed December 8th, 2016.
Definition / General
  • Cells twice as tall as wide comprise 50% of tumor, have abundant eosinophilic cytoplasm and papillary nuclear features
  • 4 - 10% of papillary thyroid carcinomas (World J Surg 2008;32:1535)
  • Usually older age
  • Often underdiagnosed (Thyroid 2008;18:1179)
Clinical Features
Prognostic Factors
Case Reports
Gross Description
  • Usually large (> 6 cm) with extrathyroidal extension
Micro Description
  • Intricate, well formed, long papillae lined by single layer of tall columnar cells (height is twice width) with sharply delineated cell borders, intensely eosinophilic, finely granular cytoplasm
  • Nuclei are enlarged with grooves, chromatin clearing and pseudoinclusions but no nuclear stratification
  • Often with lymphocytic thyroiditis, prominent vascular invasion, mitotic activity
  • No squamoid morules

  • Note: tall cells should comprise > 50% of tumor cells for diagnosis
Micro Images

Images hosted on PathOut server:

Courtesy of Andrey Bychkov, M.D., Ph.D.

Abundant acidophilic cytoplasm (AFIP)

Tall epithelial cells (AFIP)



Images hosted on other servers:

Columnar cell type (top) versus tall cell type (bottom)

“Frosted glass core” appearance

RET staining

Collision tumor with Hurthle cell carcinoma

Cytology Description
  • Tall cells (30% of aspirated cells) with well-defined granular eosinophilic cytoplasm, nuclei with nuclear grooves or intracytoplasmic inclusions which resemble “soap bubbles” due to multiple inclusions in same nucleus (Diagn Cytopathol 2002;27:143)
  • Also lymphocytes (Acta Cytol 2004;48:325)
Cytology Images

Images hosted on other servers:

Some cells are elongated
with cytoplasmic tails



Metastasis to pancreas

Left: nuclear groove (long arrow)
and intranuclear inclusion (short arrow);
right: intranuclear inclusion (arrow)

Cell block shows papillary
cluster of tall tumor cells with
abundant oncocytic cytoplasm

Molecular / Cytogenetics Description