通过细针穿刺抽吸活检（FNA）细胞学诊断的甲状腺髓外造血。病例报告。
Extramedullary hematopoiesis of the thyroid gland diagnosed by FNA cytology. A case report.
作者信息
Fassina A, Fedeli U, Borsato S
机构信息
Institute of Pathology and Cytopathology, Faculty of Medicine, University of Padova, Italy.
出版信息
Acta Cytol. 1999 Nov-Dec;43(6):1181-3. doi: 10.1159/000331377.
BACKGROUND
Extramedullary hematopoiesis (EMH) is the production of elements of erythroid and myeloid series at ectopic sites; when concomitant with agnogenic myeloid metaplasia, it is invariably seen in advanced disease. In EMH, involvement of the thyroid gland is extremely rare.
CASE
An 82-year-old male with thyroid enlargement underwent fine needle aspiration (FNA) cytology with a diagnosis of malignancy. A month later another FNA cytology was performed and was consistent with EMH. A complete hematologic workup subsequently allowed the diagnosis of agnogenic myeloid metaplasia.
CONCLUSION
The presence of EMH in the thyroid gland is an unusual finding, and, due to the presence of numerous giant cells, the cytologic presentation might be mistaken for anaplastic thyroid carcinoma. The differential diagnosis is based on the recognition of giant cells as megakaryocytes.
背景
髓外造血（EMH）是指在异位部位产生红系和髓系细胞成分；当与原因不明的髓样化生同时存在时，多见于晚期疾病。在髓外造血中，甲状腺受累极为罕见。
病例
一名82岁男性因甲状腺肿大接受细针穿刺（FNA）细胞学检查，诊断为恶性肿瘤。一个月后再次进行FNA细胞学检查，结果与髓外造血相符。随后进行的全面血液学检查确诊为原因不明的髓样化生。
结论
甲状腺出现髓外造血是一种不寻常的发现，并且由于存在大量巨细胞，其细胞学表现可能被误诊为未分化甲状腺癌。鉴别诊断基于将巨细胞识别为巨核细胞。
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