{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T20:14:49Z","timestamp":1783455289018,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"\n Aims<\/jats:title>\n \n TERT<\/jats:italic>\n promoter mutations are late molecular events associated with tumour dedifferentiation and aggressive behaviour in thyroid carcinomas (TCs). Although certain adverse histologic features, particularly tall cell morphology, are enriched in\n TERT<\/jats:italic>\n promoter\u2013mutated papillary thyroid carcinoma (PTC), their independent prognostic significance within the American Thyroid Association (ATA) high\u2010risk group remains uncertain. This study aimed to assess its prognostic relevance and characterize the histologic spectrum of\n TERT<\/jats:italic>\n promoter\u2013mutated TCs, including differentiated high\u2010grade thyroid carcinoma (DHGTC), to refine risk stratification.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and results<\/jats:title>\n \n We retrospectively analysed 151 TCs harbouring\n TERT<\/jats:italic>\n promoter mutations, reclassified according to the WHO 2022 classification, which includes newly defined DHGTC. The low frequency of\n TERT<\/jats:italic>\n promoter mutations in PTC (2.4%) likely reflects the reclassification of cases previously diagnosed as PTC to DHGTC. Tall cell morphology remained strongly associated with\n TERT<\/jats:italic>\n promoter mutations but did not confer additional prognostic significance within this ATA high\u2010risk group. Furthermore, applying the stricter WHO criteria for TC\u2010PTC (\u22653\u00d7 height criteria) did not enhance risk stratification. Importantly, histologic features indicative of tumour progression, including loss of polarity\/cohesiveness and early necrotic change, were frequently observed and significantly associated with aggressive clinicopathologic features. Accordingly, tumours exhibiting these features may not only reflect progression toward high\u2010grade disease but also serve as surrogate histologic indicators of underlying\n TERT<\/jats:italic>\n promoter mutations.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Our study provides valuable insights into\n TERT<\/jats:italic>\n promoter\u2013mutated TCs, broadening their recognized morphologic spectrum and highlighting the importance of incorporating such features into routine evaluation to improve risk stratification and better identify aggressive tumours.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/his.70152","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T08:48:16Z","timestamp":1776415696000},"page":"262-277","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["TERT<\/i>\n promoter\u2013mutated thyroid carcinomas: prognostic and histologic insights according to\n the WHO<\/scp>\n 2022 classification"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7459-0061","authenticated-orcid":false,"given":"Seung Eun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Pathology Konkuk University Medical Center, Konkuk University School of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0391-7415","authenticated-orcid":false,"given":"Bogyeong","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Pathology and Translational Genomics Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7221-2737","authenticated-orcid":false,"given":"Jung\u2010Sun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pathology and Translational Genomics Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9127-4642","authenticated-orcid":false,"given":"Young Lyun","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Pathology and Translational Genomics Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul 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