Papillary thyroid carcinoma has a number of unique morphologic features. I mentioned psammoma bodies a few days ago. Illustrated above is another characteristic feature: Orphan Annie nuclei. These are so named because they have a “cleared-out” appearance, similar to Little Orphan Annie’s eyes. In fact, you can think of papillary thyroid carcinoma as the Little Orphan Annie tumor because:

1. It stays around for years and years without getting any bigger (papillary carcinoma is slow growing).
2. It is well-behaved and seldom kills people (overall, the 10-year survival for papillary carcinoma is >90%, which is better than the prognosis of any of the other types of thyroid carcinoma).
3.  The nuclei resemble Little Orphan Annie’s eyes.
4.  It often has psammoma bodies (derived from the Greek psammos, or sand): Annie’s dog is named Sandy.

I wish I could say I came up with this, but it comes from Ed’s Pathology Notes, a really wonderful pathology site for students (and anyone interested in pathology) at