Liu L H, Bakhos R, Wojcik E M
Department of Pathology, Loyola University Medical Center, Maywood, IL 60153, USA.
Semin Diagn Pathol. 2001 May;18(2):99-103.
An association between papillary thyroid carcinoma (PTC) and Hashimoto's thyroiditis (HT) is well recognized. Both entities may often display overlapping morphologic features. The aim of this study was to evaluate the accuracy of fine needle aspiration (FNA) of concomitant PTC and HT. Twenty nine thyroid FNAs with a diagnosis of concomitant PTC and HT on follow-up surgical material were retrospectively reviewed (11% of all HT cases diagnosed in the same period of time). The cytologic specimens were evaluated for the presence of diagnostic features of PTC and HT. In 16 of 29 cases, the diagnosis of PTC was made or suggested; however, only in 3 cases were both entities recognized on the FNA material. The review of the remaining cases (13 cases) showed diagnostic features of PTC in 2 cases (interpretation errors), some features of PTC in 8 cases (insufficient diagnostic features), features of only HT in 2 cases, and 1 case was acellular (sampling errors). Originally, 10 cases with features of PTC were diagnosed as either follicular neoplasm or colloid nodule with or without HT. Histologically, 1 of 13 cases was a cystic variant and 7 of 13 cases were follicular variants of papillary carcinoma. It is important to be aware of the coexistence of PTC and HT. Deliberate search for evidences of PTC in every case of HT may be necessary to improve diagnostic accuracy of the FNA. However, the cytologic diagnosis of follicular variant of PTC coexisting with HT can be challenging. The sampling error may also cause false negative results.
甲状腺乳头状癌（PTC）与桥本甲状腺炎（HT）之间的关联已得到充分认识。这两种疾病常常会表现出重叠的形态学特征。本研究的目的是评估细针穿刺抽吸（FNA）对合并PTC和HT的诊断准确性。回顾性分析了29例甲状腺FNA病例，这些病例在后续手术材料中被诊断为合并PTC和HT（占同期所有HT病例的11%）。对细胞标本进行评估，以确定是否存在PTC和HT的诊断特征。在29例病例中，16例做出了PTC的诊断或提示；然而，FNA材料中仅3例同时识别出这两种疾病。对其余病例（13例）的回顾显示，2例有PTC的诊断特征（解读错误），8例有PTC的一些特征（诊断特征不足），2例仅有HT的特征，1例无细胞（采样错误）。最初，10例有PTC特征的病例被诊断为滤泡性肿瘤或伴有或不伴有HT的胶质结节。组织学上，13例中有1例为囊性变体，13例中有7例为乳头状癌的滤泡性变体。认识到PTC和HT的共存很重要。在每例HT病例中刻意寻找PTC的证据可能对提高FNA的诊断准确性是必要的。然而，PTC滤泡性变体与HT共存的细胞学诊断可能具有挑战性。采样错误也可能导致假阴性结果。
