Poorly Differentiated (“Insular”) Thyroid Carcinoma on Fine-Needle Aspiration

IF 0.2
J. Hipp, Syed Z. Ali, C. VandenBussche
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引用次数: 1

Abstract

Abstract Poorly differentiated thyroid carcinoma (PDTC) is a distinct entity of thyroid follicular origin (without follicular or papillary differentiation), with high-grade features and an aggressive clinical behavior intermediate between that of well-differentiated and undifferentiated thyroid carcinoma. It accounts for 4% to 7% of thyroid malignancies. Poorly differentiated thyroid carcinoma often presents at an advanced stage and tends to metastasize to regional lymph nodes, lungs, and bones. A variety of histological patterns exists for PDTC and the corresponding cytomorphological features are also varied and depend on the growth pattern of the individual neoplasm. We report the cytomorphology of PDTC sampled by fine-needle aspiration and review previously reported cases in the literature. While PDTC do not possess specific cytomorphological features that would allow for a definitive diagnosis on fine-needle aspiration, the presence of certain features may suggest the possibility of this rare neoplasm. In particular, cells with overlapping bland nuclei found both in groups and individually are common features. Lesions are often cellular and lack colloid, providing the sense of a neoplasm. It may be difficult to exclude the more common possibility of a papillary thyroid carcinoma or follicular neoplasm; however, familiarity with this uncommon entity allows one to include it in the differential diagnosis.
细针穿刺显示低分化甲状腺癌
低分化甲状腺癌(PDTC)是一种起源于甲状腺滤泡(无滤泡或乳头状分化)的独特肿瘤,具有高级别特征,临床表现介于高分化和未分化甲状腺癌之间。它占甲状腺恶性肿瘤的4%至7%。低分化甲状腺癌通常出现在晚期,并倾向于转移到局部淋巴结、肺和骨骼。PDTC存在多种组织学模式,相应的细胞形态学特征也各不相同,并取决于单个肿瘤的生长模式。我们报告了通过细针穿刺取样的PDTC的细胞形态学,并回顾了文献中先前报道的病例。虽然PDTC没有特定的细胞形态学特征,无法对细针穿刺进行明确诊断,但某些特征的存在可能提示这种罕见肿瘤的可能性。特别是,在群体和个体中发现的具有重叠的淡核的细胞是共同的特征。病变通常是细胞性的,缺乏胶质,给人肿瘤的感觉。很难排除更常见的甲状腺乳头状癌或滤泡性肿瘤的可能性;然而,熟悉这种不常见的实体允许一个包括它在鉴别诊断。
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期刊介绍: Each issue of Pathology Case Reviews examines one vital theme in the field with peer-reviewed, clinically oriented case reports that focus on diagnosis, specimen handling and reports generation. Each theme-oriented issue covers both histopathologic and cytopathologic cases, offering a comprehensive perspective that includes editorials and review articles of the newest developments in the field, differential diagnosis hints, applications of new technologies, reviews of current issues and techniques and an emphasis on new approaches.
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