摘要
目的:探讨经超声引导下行细针抽吸术(fine-needle aspiration,FNA),术后诊断为甲状腺具有乳头状核特征的非浸润性滤泡性肿瘤(noninvasive follicular thyroid neoplasm with papillary-like nuclear features,NIFTP)的细胞学病理特征、诊断和鉴别诊断、治疗、预后及分子特征。方法:从病例库中筛选出细胞学诊断为可疑恶性肿瘤术后诊断为NIFTP的病例6例,每例FNA样本制作为传统涂片和液基制片,分别行苏木素-伊红(hematoxylin-eosin,HE)染色和巴氏染色。由两位高年资细胞病理专科医生重新评估其细胞病理学特征,并结合相关文献进行回顾性分析、总结。结果:镜下,我们发现NIFTP的细胞学表现,虽与甲状腺乳头状癌(papillary thyroid carcinoma,PTC)存在一定的重叠(两者均表现为核增大,核毛玻璃样,可见核沟),但与PTC又有所不同:前者形成微滤泡样结构的细胞成片分布或单个微滤泡散在分布,不存在乳头状结构;另外,NIFTP核圆,核膜光滑,核内假包涵体少见。结论:本文回顾性分析并总结了NIFTP的临床特征、细胞病理特点、鉴别诊断、治疗、预后及分子特征。我们发现FNA样本中NIFTP与其他甲状腺肿瘤之间存在不同的诊断线索,有助于细胞病理医师做出更客观准确的判读,也有助于指导临床选择合适的治疗方案。
Objective:To investigate the cytological and pathological features,diagnosis and differential diagnosis,treatment,prognosis and molecular characteristics of cytological samples,which were obtained by ultrasound-guided fine-needle aspiration(FNA)and diagnosed as noninvasive follicular thyroid neoplasm with papillary-like nuclear features(NIFTP)postoperatively.Methods:We had screened 6 cases diagnosed as suspected malignant tumor by cytology and diagnosed as NIFTP through operation from the database.Each case was made into conventional smears and liquid-based smears,and stained by the HE and Papanicolaouataining respectively.And the cytopathologic features were reassessed and summarized by two senior cytopathologist in combination with related literature review.Results:Although the cytological features of NIFTP overlapped with papillary thyroid carcinoma(PTC)to some extent microscopically(both of them presented with enlarged,ground-glass like nuclei and prominent longitudinal grooves),we found that they were different from PTC in some respects.The former showed microfollicular-patterned cells distributed in sheets or scattered single microfollicles without papillary structure formed.In addition that,NIFTP had round nuclei,smooth nuclear membranes and rare pseudoinclusion bodies.Conclusion:Six FNA cytological samples of NIFTP were selected,and the clinical features,cytopathological features,differential diagnosis,treatment,prognosis and molecular characteristics of the patients were reanalyzed.Although it is very challenging,we found some diagnostic clues between NIFTP and other thyroid tumors in FNA samples,which may be helpful for cytopathologists to make accurate diagnosis and guide clinicians to select appropriate treatment and evaluate prognosis for patients.
作者
杨巧
王佩
郭英
刘坦坦
YANG Qiao;WANG Pei;GUO Ying;LIU Tantan(Department of Pathology,Xi'an Daxing Hospital,Shaanxi Xi'an 710016,China;Department of Pathology,Weinan Central Hospital,Shaanxi Weinan 714000,China;Department of Pathology,the First Affiliated Hospital of Air Force Medical University(Xijing Hospital),Shaanxi Xi'an 710032,China;Northwest Women's and Children's Hospital,Shaanxi Xi'an 710061,China)
出处
《现代肿瘤医学》
CAS
2024年第9期1627-1631,共5页
Journal of Modern Oncology
