Sharma Prashant, Kumar Neeta, Gupta Ruchika, Jain Shyama
Cytopathology Laboratory, Department of Pathology, Maulana Azad Medical College, Lok Nayak Hospital, New Delhi, India.
Acta Cytol. 2004 Mar-Apr;48(2):219-22. doi: 10.1159/000326320.
Follicular carcinoma of the thyroid in association with hyperthyroidism is rare. The malignant lesion may remain occult for a long time. Certain clinical and cytologic features may be helpful in raising the alarm.
An elderly male with a history of occupational exposure to X rays, long-standing toxic multinodular goiter and clinical hyperthyroidism presented with a rapidly enlarging mass in the neck. Cytologic smears showed a prominent microfollicular pattern, scanty colloid, anisonucleosis and nuclear overlapping. The noteworthy feature was the presence of marginal vacuoles. The cytologic diagnosis of follicular neoplasm with highly suggestive malignancy was made. Subsequently, multiple pulmonary nodules provided radiologic evidence of possible metastatic spread.
This case report demonstrates the rare association of follicular carcinoma of the thyroid with hyperthyroidism and analyzes certain high-risk clinical and cytologic features to be considered in the follow-up of long-standing hyperfunctioning multinodular goiter.
甲状腺滤泡癌合并甲状腺功能亢进症较为罕见。恶性病变可能长期隐匿。某些临床和细胞学特征可能有助于发出警示。
一名老年男性，有职业性接触X射线史、长期毒性多结节性甲状腺肿和临床甲状腺功能亢进症，出现颈部迅速增大的肿块。细胞学涂片显示显著的微滤泡模式、少量胶质、核大小不一和核重叠。值得注意的特征是边缘空泡的存在。做出了具有高度恶性提示的滤泡性肿瘤的细胞学诊断。随后，多个肺结节提供了可能转移扩散的影像学证据。
本病例报告展示了甲状腺滤泡癌与甲状腺功能亢进症的罕见关联，并分析了在长期高功能多结节性甲状腺肿随访中应考虑的某些高危临床和细胞学特征。
