诊断挑战的FNA细胞学沉淀:一个病例报告和文献回顾。

IF 2.3 3区 医学 Q2 PATHOLOGY
Evelyn O Ilori, Hanan Hamdan, Venetia Sarode, Iram Hussain, Ana Islam, Justin A Bishop
{"title":"诊断挑战的FNA细胞学沉淀:一个病例报告和文献回顾。","authors":"Evelyn O Ilori, Hanan Hamdan, Venetia Sarode, Iram Hussain, Ana Islam, Justin A Bishop","doi":"10.1186/s13000-025-01682-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Spindle epithelial tumor with thymus-like differentiation or elements (SETTLE) is a rare and malignant biphasic tumor of the thyroid that has proven challenging to diagnose by cytology.</p><p><strong>Case presentation: </strong>A 20-year-old-male presented with a large left neck nodule and neck tightness. Laboratory tests were normal. Computed Tomography (CT) of the neck revealed a thyroid mass involving the isthmus and entire left lobe. Ultrasound-guided fine needle aspiration of the mass demonstrated sheets and clusters of oval to spindle cells with associated fibrovascular cores. The cells had moderately pleomorphic nuclei with stippled chromatin, inconspicuous nucleoli, and minimal cytoplasm, and a diagnosis of medullary thyroid carcinoma was made. A total thyroidectomy and neck dissection was performed. Morphological and immunohistochemical evaluation of the specimen resulted in a diagnosis of SETTLE with angioinvasion and involved lymph nodes.</p><p><strong>Conclusion: </strong>SETTLE has several mimics cytologically, such as medullary thyroid carcinoma, that makes accurate pre-operative diagnosis challenging. We present a review of cytology information from literature, highlighting features that differentiates SETTLE from its mimics.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"20 1","pages":"88"},"PeriodicalIF":2.3000,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308978/pdf/","citationCount":"0","resultStr":"{\"title\":\"Diagnostic challenges of FNA cytology of SETTLE: a case report and review of the literature.\",\"authors\":\"Evelyn O Ilori, Hanan Hamdan, Venetia Sarode, Iram Hussain, Ana Islam, Justin A Bishop\",\"doi\":\"10.1186/s13000-025-01682-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Spindle epithelial tumor with thymus-like differentiation or elements (SETTLE) is a rare and malignant biphasic tumor of the thyroid that has proven challenging to diagnose by cytology.</p><p><strong>Case presentation: </strong>A 20-year-old-male presented with a large left neck nodule and neck tightness. Laboratory tests were normal. Computed Tomography (CT) of the neck revealed a thyroid mass involving the isthmus and entire left lobe. Ultrasound-guided fine needle aspiration of the mass demonstrated sheets and clusters of oval to spindle cells with associated fibrovascular cores. The cells had moderately pleomorphic nuclei with stippled chromatin, inconspicuous nucleoli, and minimal cytoplasm, and a diagnosis of medullary thyroid carcinoma was made. A total thyroidectomy and neck dissection was performed. Morphological and immunohistochemical evaluation of the specimen resulted in a diagnosis of SETTLE with angioinvasion and involved lymph nodes.</p><p><strong>Conclusion: </strong>SETTLE has several mimics cytologically, such as medullary thyroid carcinoma, that makes accurate pre-operative diagnosis challenging. We present a review of cytology information from literature, highlighting features that differentiates SETTLE from its mimics.</p>\",\"PeriodicalId\":11237,\"journal\":{\"name\":\"Diagnostic Pathology\",\"volume\":\"20 1\",\"pages\":\"88\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-07-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308978/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diagnostic Pathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13000-025-01682-7\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PATHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diagnostic Pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13000-025-01682-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PATHOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:梭形上皮肿瘤伴胸腺样分化或元素(SETTLE)是一种罕见的甲状腺双相恶性肿瘤,已被证明具有细胞学诊断的挑战性。病例介绍:一名20岁男性,因左侧颈部大结节及颈部紧绷。实验室检查正常颈部计算机断层扫描(CT)显示甲状腺肿块累及峡部和整个左叶。超声引导下细针穿刺肿块显示片状和成团的卵圆形梭形细胞及相关的纤维血管核。细胞核呈中等多形性,染色质斑点,核仁不明显,细胞质较少,诊断为甲状腺髓样癌。行甲状腺全切除术及颈部清扫术。标本的形态学和免疫组织化学评估结果诊断为血管浸润和累及淋巴结。结论:SETTLE有几种细胞学上的类似物,如甲状腺髓样癌,这使得准确的术前诊断具有挑战性。我们从文献中提出细胞学信息的回顾,突出特点,从它的模仿区分SETTLE。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Diagnostic challenges of FNA cytology of SETTLE: a case report and review of the literature.

Diagnostic challenges of FNA cytology of SETTLE: a case report and review of the literature.

Diagnostic challenges of FNA cytology of SETTLE: a case report and review of the literature.

Background: Spindle epithelial tumor with thymus-like differentiation or elements (SETTLE) is a rare and malignant biphasic tumor of the thyroid that has proven challenging to diagnose by cytology.

Case presentation: A 20-year-old-male presented with a large left neck nodule and neck tightness. Laboratory tests were normal. Computed Tomography (CT) of the neck revealed a thyroid mass involving the isthmus and entire left lobe. Ultrasound-guided fine needle aspiration of the mass demonstrated sheets and clusters of oval to spindle cells with associated fibrovascular cores. The cells had moderately pleomorphic nuclei with stippled chromatin, inconspicuous nucleoli, and minimal cytoplasm, and a diagnosis of medullary thyroid carcinoma was made. A total thyroidectomy and neck dissection was performed. Morphological and immunohistochemical evaluation of the specimen resulted in a diagnosis of SETTLE with angioinvasion and involved lymph nodes.

Conclusion: SETTLE has several mimics cytologically, such as medullary thyroid carcinoma, that makes accurate pre-operative diagnosis challenging. We present a review of cytology information from literature, highlighting features that differentiates SETTLE from its mimics.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Diagnostic Pathology
Diagnostic Pathology 医学-病理学
CiteScore
4.60
自引率
0.00%
发文量
93
审稿时长
1 months
期刊介绍: Diagnostic Pathology is an open access, peer-reviewed, online journal that considers research in surgical and clinical pathology, immunology, and biology, with a special focus on cutting-edge approaches in diagnostic pathology and tissue-based therapy. The journal covers all aspects of surgical pathology, including classic diagnostic pathology, prognosis-related diagnosis (tumor stages, prognosis markers, such as MIB-percentage, hormone receptors, etc.), and therapy-related findings. The journal also focuses on the technological aspects of pathology, including molecular biology techniques, morphometry aspects (stereology, DNA analysis, syntactic structure analysis), communication aspects (telecommunication, virtual microscopy, virtual pathology institutions, etc.), and electronic education and quality assurance (for example interactive publication, on-line references with automated updating, etc.).
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信