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This study aims to evaluate the preoperative cytologic findings and clinicopathologic features of a series of eight\n                    <jats:italic>ALK<\/jats:italic>\n                    -rearranged PTCs from our pathology archives and consultations. All cases were confirmed by ALK D5F3 immunohistochemistry and six with additional targeted RNA-based next-generation sequencing (NGS). The original fine-needle aspiration (FNA) cytology diagnosis included the Bethesda System (TBS) category II in three (37.5%), TBS III in two (25%), TBS V in two (25%), and TBS VI in one (12.5%). Six cases had available FNA cytology and were reviewed. The cytologic features showed microfollicular architecture as well as\u00a0limited or reduced\u00a0nuclear elongation and  chromatin alterations in all six. Nuclear grooves and pseudoinclusions were absent in two cases, rarely or focally noted in three, and frequently found in one. Two cases initially diagnosed as\u00a0TBS II, showing microfollicular architecture without well-developed nuclear features, were revised to TBS III (with architectural atypia only). For histologic correlations, four were infiltrative follicular variant PTCs, three as classic subtype PTC with predominant follicular growth, and one as solid\/trabecular subtype PTC. All eight cases demonstrated reduced\u00a0PTC nuclear features with respect to nuclear elongation and chromatin alterations compared to those\u00a0typically identified in \u201c\n                    <jats:italic>BRAF<\/jats:italic>\n                    -like\u201d PTCs. The NGS testing revealed\n                    <jats:italic>EML4::ALK<\/jats:italic>\n                    fusion in three,\n                    <jats:italic>STRN::ALK<\/jats:italic>\n                    fusion in two, and\n                    <jats:italic>ITSN2::ALK<\/jats:italic>\n                    fusion in one. In conclusion, although\n                    <jats:italic>ALK<\/jats:italic>\n                    -rearranged PTCs have been associated with neutral gene expression profile from a\n                    <jats:italic>BRAF-RAS<\/jats:italic>\n                    scoring perspective, the \u201c\n                    <jats:italic>RAS<\/jats:italic>\n                    -like\u201d nuclear features were more commonly identified in this series, resulting in frequent indeterminate diagnosis of preoperative FNA.\n                  <\/jats:p>","DOI":"10.1007\/s12022-024-09808-1","type":"journal-article","created":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T02:02:01Z","timestamp":1713578521000},"page":"134-146","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Clinicopathologic Features and Cytologic Correlation of ALK-Rearranged Papillary Thyroid Carcinoma: A Series of Eight Cases"],"prefix":"10.1007","volume":"35","author":[{"given":"Kun-Ping","family":"Shih","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Cheng","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Jiun","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Hui","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Yi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan-Shan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-Feng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4299-2784","authenticated-orcid":false,"given":"Jen-Fan","family":"Hang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,20]]},"reference":[{"key":"9808_CR1","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/s2213-8587(21)00027-9","volume":"9","author":"A Miranda-Filho","year":"2021","unstructured":"Miranda-Filho A, Lortet-Tieulent J, Bray F et al. 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