弥漫硬化型甲状腺乳头状癌的超声及细针穿刺细胞学特征分析  

Analysis of characteristics of ultrasound and fine needle aspiration cytology in patients with diffuse sclerosing variant of papillary thyroid carcinoma

作　　者：许田田 尹艳华[1] XU Tiantian;YIN Yanhua(Department of Pathology,Liaocheng People's Hospital,Shandong Liaocheng 252000,China)

机构地区：[1]聊城市人民医院病理科,山东聊城252000

出　　处：《现代肿瘤医学》2022年第18期3299-3303,共5页Journal of Modern Oncology

摘　　要：目的:分析弥漫硬化型甲状腺乳头状癌(diffuse sclerosing variant of papillary thyroid carcinoma,DSVPTC)的临床病理学特点,总结DSVPTC超声及超声引导下细针穿刺细胞学(fine needle aspiration cytology,FNAC)检查的术前诊断特征。方法:回顾性分析9例DSVPTC的临床、超声资料、细针穿刺细胞学及组织病理学特征。结果:9例DSVPTC中女性7例,男性2例;7例(77.8%)可见被膜侵犯,8例(88.9%)可见脉管内瘤栓,9例(100%)出现淋巴结转移。超声表现为4例(44.4%)在单侧或双侧甲状腺内见弥散分布的砂粒样钙化,呈“暴风雪”样改变,5例(55.6%)在单侧腺体内呈结节样的不均质区,边界不清。9例术前均行超声引导下FNAC检查,细胞学主要特征为:较多砂砾体、大量淋巴细胞浸润,排列紧密的三维立体细胞簇及排列松散的鳞状化生细胞。结合超声及FNAC检查,DSVPTC术前诊断率为77.8%。结论:DSVPTC侵袭性较强,超声及FNAC检查对于DSVPTC的术前诊断具有较高的准确率,有利于患者早期诊断及手术方案的制定。Objective:To investigate the clinicopathological features of diffuse sclerosing variant of papillary thyroid carcinoma(DSVPTC)and to analyze its diagnostic characteristics of ultrasound and ultrasound-guided fine needle aspiration cytology(FNAC)before operation.Methods:9 cases diagnosed with pathologically proven DSVPTC were enrolled.The clinical features,ultrasonic features,FNAC and histopathological features were reviewed to analyze retrospectively.Results:Of these nine patients,there were seven females and two males.7 cases(77.8%)of DSVPTC showed capsule invasion,8 cases(88.9%)of DSVPTC showed lymphovascular invasion,lymph node metastasis occurred in 9 cases(100%).Of the 9 ultrasound images,four(44.4%)showed diffuse,scattered microcalcifications having snowstorm appearance in one or both thyroid lobes,five(55.6%)had various typies of echogenicity which combined with irregular shape in one thyroid lobes.All of these nine patients underwented preoperative FNAC,cytological findings of DSVPTC were as follows:Abundant psammoma bodies,a large number of lymphocytes,compact three-dimensional clusters and loosely clustered squamousmetaplasia cells.The preoperative diagnostic rate of DSVPTC was 77.8%.Conclusion:DSVPTC is a thyroid papillary carcinoma variant characterized by high aggressiveness.The preoperative accuracy rates of ultrasound and FNAC diagnosis for patients with DSVPTC are high.The two examinations before operation are helpful for early diagnosis and surgical managementfor patients with DSVPTC.

关 键 词：甲状腺乳头状癌 超声 细针穿刺细胞学 弥漫硬化型 早期诊断 

分 类 号：R736.1[医药卫生—肿瘤]