Baloch Zubair W, LiVolsi Virginia A
Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Adv Anat Pathol. 2006 Mar;13(2):69-75. doi: 10.1097/01.pap.0000213006.10362.17.
Thyroid microcarcinoma, defined as a thyroid tumor measuring 1 cm or less, is an extremely indolent tumor. Papillary microcarcinoma, the most common subtype, is often identified incidentally in a thyroid removed for benign clinical nodules or diffuse processes (eg, thyroiditis). In this clinical situation, over 99% are cured by simple lobectomy. In the less common scenario, the microcarcinoma is the primary lesion to a lymph node metastasis presenting clinically as a neck mass; in this situation, the tumor should be treated as a clinical cancer. Other rare microcarcinomas can occur and, of these, the most recently described is micromedullary carcinoma. In the familial setting, these lesions are identified in prophylactic thyroidectomies and are not unexpected findings. However, when found as sporadic tumors, their implications are still unknown. The histologic features, pathologic mimics, and molecular facets of these microscopic neoplasms are discussed in this review.
甲状腺微小癌被定义为直径1厘米或更小的甲状腺肿瘤，是一种生长极为缓慢的肿瘤。乳头状微小癌是最常见的亚型，常常在因良性临床结节或弥漫性病变（如甲状腺炎）而切除的甲状腺中偶然发现。在这种临床情况下，超过99%的患者通过单纯甲状腺叶切除术即可治愈。在较不常见的情况下，微小癌是临床上表现为颈部肿块的淋巴结转移的原发病变；在这种情况下，该肿瘤应被视为临床癌症进行治疗。还可出现其他罕见的微小癌，其中最近描述的是微髓样癌。在家族性病例中，这些病变在预防性甲状腺切除术中被发现，并非意外发现。然而，当作为散发性肿瘤被发现时，其意义仍不明确。本文综述将讨论这些微小肿瘤的组织学特征、病理模拟物及分子方面。
