The ‘dark nucleus’ and disruptions of follicular architecture: possible new histological aids for the diagnosis of the follicular variant of papillary carcinoma of the thyroid
Bibliographic record
Abstract
AIMS: In order to facilitate the diagnosis of malignancy in solitary thyroid nodules which are non-invasive low-grade tumours, i.e. follicular variant of papillary carcinoma (FVPC) for which few histological discriminators exist, a search was made for additional diagnostically useful histological features. METHODS AND RESULTS: Haematoxylin and eosin (H & E)-stained sections of 70 resection specimens of solitary thyroid nodules were re-evaluated by a panel of three pathologists, and their consensus and original diagnoses compared. In addition, H & E- and periodic acid-Schiff-stained sections were evaluated for various histological features and sections were stained by various immunohistochemical markers to evaluate their discriminative powers. The above features were also assessed in a group of 24 papillary carcinomas of the thyroid (PTCs) associated with regional metastases. The finding of 'Orphan Annie eye' nuclei was the best indicator of malignancy, and was closely related to the presence of nuclear grooves and cells with dense, dark nuclei. In addition, distorted follicular architectural features, i.e. 'interconnecting cell masses' and 'fenestration', were also significant indicators of malignancy. Tumours diagnosed as FVPCs had a significantly lower incidence of associated lymph node metastases than the classical PTCs. CONCLUSIONS: The use of optically clear nuclei as a diagnostic criterion when found only focally may not be sufficiently stringent in distinguishing FVPCs from follicular adenomas. When classical histological indicators of malignancy are equivocal, the diagnosis of FVPC may be facilitated by the above-mentioned features.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".