Which variant of papillary thyroid carcinoma has the WORST prognosis with a 10-year disease-specific mortality approaching 65%, and is classified separately in TNM staging?
- A Follicular variant
- B Tall cell variant
- C Columnar cell variant ✓
- D Diffuse sclerosing variant
Correct answer: C. Columnar cell variant
Explanation
The columnar cell variant of papillary thyroid carcinoma is the most aggressive subtype with a 10-year mortality approaching 65%, characterised by tall pseudostratified columnar cells, subnuclear vacuoles resembling early secretory endometrium, and frequent distant metastases. It is staged separately in the WHO classification. The tall cell variant is also aggressive but carries a better prognosis than columnar cell. The follicular variant behaves more like follicular carcinoma.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.