Comics in Medicine_The Orphan Annie

Note the vacant eyes

A famous 1900's daily American comic strip, Little Orphan Annie illustrated its lead character as a girl with red hair, red dress, and vacant circles for eyes.

Papillary Carcinoma of the thyroid gland(PCT) is characterised by 2 distinct features on light microscopy, namely Orphan Annie eye nuclei and Psammoma bodies.

In PCT,the cells of the thyroid gland i.e., the thyrocytes are large and show an abnormal nucleus and cytoplasm with several mitoses. 

The thyrocytes have characteristic "Orphan Annie eye nuclei" as explained in the figure below. 

The hand drawn illustration of Orphan Annie-eye nuclei reveals large nuclei cleared out in the center
with powdery chromatin marginated to the periphery along with few open- and close-faced nuclei.
1=Orphan Annie-eye nuclei, 2=open-faced nuclei, 3=closed-faced nuclei

Reference Link

These are so named because they have a “cleared-out” appearance, similar to Little Orphan Annie’s eyes. This optically clear or empty appearance is also described as 'ground glass appearance'

Features of Orphan Annie-eye nuclei in histopathology include:

• Large nuclei with singular membranes 
• Nuclei with finely dispersed chromatin, which imparts an optically clear or empty appearance
• Nuclear grooves(Invaginations of the nuclear envelope bilayer, which constitute a characteristic feature of papillary thyroid carcinoma)
• Nuclei that are often seen overlapping each other

Photomicrograph showing numerous Orphan Annie-eye nuclei with few hyperchromatic and vesicular nuclei.
 1=Orphan Annie-eye nuclei, 2=open-faced nuclei, 3=closed-faced nuclei
Also note the overlapping cells and other histological features.

Reference Link

Papillary thyroid cancer is also characterised by psammoma bodies (derived from the Greek psammos, or sand): in the comic strip, Annie’s dog is named Sandy.

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Suggested references:
Robbins Basic Pathology textbook_click for pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830218/