Kikuchi Inako, Anbo Junichi, Nakamura Shin-ichi, Sugai Tamotsu, Sasou Shunichi, Yamamoto Masahide, Oda Yoshino, Shiratsuchi Hideki, Tsuneyoshi Masazumi
Division of Pathology, Central Clinical Laboratory, Morioka, Japan.
Acta Cytol. 2003 May-Jun;47(3):495-500. doi: 10.1159/000326558.
Synovial sarcoma, generally known as a soft tissue tumor, can also occur in the head and neck region, including the thyroid gland. Cytologic findings are important to differentiate the tumor from other types of neoplasms arising in the thyroid gland.
A 60-year-old man complained of hoarseness. A palpable neck tumor was detected, and a computed tomography scan showed a thyroid tumor accompanied by destruction of the thyroid and cricoid cartilage. The results of a preoperative fine needle aspiration biopsy showed numerous spindle cells with pale cytoplasm and oval nuclei with fine, granular chromatin, all of which suggested a medullary carcinoma. The extirpated thyroid tissue weighed approximately 120 g, and a grayish white, elastic, solid tumor (6.8 x 6.5 cm) was present in the left lobe. Histologically, fasciculation of spindle cells that had proliferated solidly and densely was observed. Also, the expression of a chimera gene, SYT-SSX, was detected in the tumor tissue.
Synovial sarcoma of the thyroid is extremely rare, and its diagnosis by fine needle aspiration biopsy is generally considered very difficult. The detailed cytologic findings observed here might be helpful with the differential diagnosis of thyroid neoplasms.
滑膜肉瘤通常被认为是一种软组织肿瘤，也可发生于头颈部区域，包括甲状腺。细胞学检查结果对于鉴别该肿瘤与甲状腺发生的其他类型肿瘤很重要。
一名60岁男性主诉声音嘶哑。检查发现颈部有可触及的肿物，计算机断层扫描显示甲状腺肿瘤伴甲状腺及环状软骨破坏。术前细针穿刺活检结果显示有大量梭形细胞，胞质淡染，细胞核呈椭圆形，染色质细腻、呈颗粒状，所有这些提示为髓样癌。切除的甲状腺组织重约120克，左叶有一个灰白色、质地坚韧的实性肿瘤（6.8×6.5厘米）。组织学检查可见梭形细胞呈束状紧密增殖。此外，在肿瘤组织中检测到嵌合基因SYT-SSX的表达。
甲状腺滑膜肉瘤极为罕见，一般认为通过细针穿刺活检诊断该病非常困难。此处观察到的详细细胞学检查结果可能有助于甲状腺肿瘤的鉴别诊断。
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