The aim of this study was to provide the first systematic description of human placental cytology appearances and to investigate syncytiotrophoblast nuclear organisation patterns using cytology techniques. Term placentas from normal pregnancies were sampled using fine-needle aspiration (FNA) and direct scrapes. Standard histological examination was also performed to exclude pathological changes in the placentas being studied. Both Papanicolaou-stained cytospin preparations and air-dried Giemsa slides from FNA provided high-quality material for cytological assessment with good cellularity. Among the key features of the cytology preparations were villous “microbiopsies” that allowed for the three-dimensional appreciation of villous branching patterns. Cytological appearances, including nuclear characteristics of villous cytotrophoblast and syncytiotrophoblast, were also well demonstrated. In microbiopsies and detached villous trophoblast sheets, complex patterns of syncytiotrophoblast nuclear organisation, not previously described cytologically, were observed, including irregular spacing of nuclei, syncytioplasm windows and linear nuclear arrangements. This study showed that placental cytology (a) provides technically excellent material for cytological evaluation, (b) confirms the presence of complex nuclear organisational patterns in the syncytiotrophoblast by eliminating the possibility of tangential sectioning artefact, (c) provides superior nuclear detail over standard histological sections and (d) may be an untapped research resource for the investigation of normal and pathological processes because of its ability to look at the placenta in a novel way and through its potential for both ex vivo and in vivo placental sampling.

Anaplastic thyroid cancer (ATC) is considered to be one of the most virulent, treatment-refractory malignancies. Recent molecular insights into the biology of thyroid cancer have transformed ATC management, and BRAF/MEK targeted therapy is now incorporated into guideline-based multidisciplinary care. We report visceral perforation in the setting of an extreme response to such therapy in a patient with ATC. Molecularly targeted therapy afforded a dramatic but life-threatening response to treatment. This report highlights the complexities of care for the patient and treating clinicians.

Anaplastic thyroid cancer (ATC) is considered to be one of the most virulent, treatment refractory, malignancies. Recent molecular insights into the biology of thyroid cancer have transformed ATC management and BRAF/MEK targeted therapy is now incorporated into guideline based multidisciplinary care. We report visceral perforation in the setting of an extreme response to such therapy in a patient with a mixed papillary thyroid carcinoma and ATC. Molecularly targeted therapy afforded a dramatic, but life-threatening, response to treatment. This report highlights the complexities of care for the patient and treating clinicians.