甲状腺滤泡型乳头状癌的超声表现与病理对照研究  

Comparative study on ultrasonic appearances and pathological features of follicular variant of papillary thyroid carcinoma

作　　者：杨帆[1] 陈贤翔[2] 吴火林 郭美金[1] 陈媛[1] 

机构地区：[1]解放军第92医院特诊科,福建南平353000 [2]解放军第92医院病理科,福建南平353000

出　　处：《中华临床医师杂志（电子版）》2013年第18期73-75,共3页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨甲状腺滤泡型乳头状癌(FVPTC)的超声表现及其与病理改变的关系。方法回顾性分析38例经手术和病理证实的FVPTC患者的超声表现,并进行病理对照研究。结果 38例FVPTC的超声表现可分为3种类型:(1)Ⅰ型8例(21%),具备甲状腺乳头状癌的典型超声表现,结节形态不规则,边界不清,内部可呈极低回声,可见微小钙化;(2)Ⅱ型15例(39.5%),表现为边界较清晰的等回声或低回声结节,其形态不规则,边缘可见成角或分叶,微小钙化较少见;(3)Ⅲ型15例(39.5%),声像图表现形似腺瘤,结节边界清晰且边缘光整,内部为均匀中等回声。结合38例FVPTC的超声表现,其镜下结构特征也可相应分为3类:(1)Ⅰ型8例,病灶无明显包膜,形态不规则,呈浸润性生长;(2)Ⅱ型15例,病灶有包膜,形态不规则,病灶对包膜侵犯明显,局部突破包膜,周边可见卫星病灶;(3)Ⅲ型15例,病灶有较为完整的包膜,形态规则,病灶对包膜无明显侵犯或累及程度和范围很小。依据病灶有无包膜情况,病理诊断Ⅰ型为非包膜内型FVPTC(8/38,21%),Ⅱ、Ⅲ型为包膜内型FVPTC(30/38,79%),以上两者的形态、边界、声晕、纵横比、内部回声、微小钙化等超声特征的显示率不同,差异有统计学意义(P<0.05),而肿瘤大小、淋巴结累及等超声特征,差异没有统计学意义(P>0.05)。结论 FVPTC的超声表现兼具滤泡性肿瘤和普通乳头状癌的特点,其超声表现的不同与其病理亚型密切相关。Objective To investigate the pathological basis of imaging and the ultrasonic appearances of follicular variant of papillary thyroid carcinoma（FVPTC）. Methods Ultrasonic appearances of 38 patients with FVPTC confirmed by surgery and pathology were analyzed retrospectively and compared with their pathological features. Results Ultrasonic appearances of 38 cases of FVPTC could be classified into three types：（1） type I 8 cases （21%）, which with typical sonographic features of papillary thyroid carcinoma：nodules with irregular shape, unclear boundary, and very low echo inside, microcalcification could be seen; （2） typeⅡ15 cases （39.5%）, ultrasonic performance：clearer iso-echoic or hypo-echoic nodules which have irregular shape, angled and lobular edge, but rarely microcalcification; （3） type Ⅲ 15 cases （39.5%）, ultrasonic performance： they look like thyroid adenoma, and the nodule of them with clear boundary and regular edge, uniform medium echo inside. With the reference of untrasonic appearances of FVPTC, their microscopic structure characteristics could accordingly be divided into three categories：type I 8 cases, the lesions with no obvious capsule were infiltrative and irregular;typeⅡ15 cases, the lesions were enveloped and irregular, which often invaded the capsule with partial protrusion and peripheral small satellite lesions;typeⅢ15 cases, the lesions had a more complete envelope, and they were more regular with no significant or lower level and smaller extent invasion of the capsule. Based on the condition of whether the lesion had envelope, the pathological diagnosis of the lesions showed that typeⅠwas unencapsulated FVPTC （8/38, 21%）, while typeⅡ and Ⅲ were encapsulated FVPTC （30/38, 79%）, both of the above show difference in displaying rate of ultrasound characteristics, such as shape, boundary, acoustic halo, aspect ratio, internal echo, and microcalcifications, and the difference was statistically significant （P〈0.05）, whereas the differen

关 键 词：甲状腺肿瘤 癌 乳头状 滤泡 超声检查 病理学 

分 类 号：R736.1[医药卫生—肿瘤]