Orlando C A, Salman K, Miller J L, Naryshkin S
Department of Pathology and Laboratory Medicine, Hahnemann University, Philadelphia, PA.
Diagn Cytopathol. 1991;7(3):273-6. doi: 10.1002/dc.2840070312.
We present a case of follicular adenoma with clear-cell change, which on fine-needle aspiration biopsy mimicked a Hürthle-cell tumor. Papanicolaou-stained smears revealed a monomorphic pattern of loosely cohesive groups of cells with abundant cytoplasm and centrally placed round nuclei with single prominent nucleoli. The cytoplasm was granular or finely vacuolated with occasional intracytoplasmic brown pigment. Subsequent surgical histology of the partial thyroidectomy specimen revealed a follicular adenoma composed of macro- and microfollicles. The microfollicular areas showed clear-cell change: these cells appeared identical to those seen on cytology. No Hürthle-cell change was present in the surgical specimen. Follicular cells with clear-cell change of the granular type must be added to the list of differential diagnoses when cells with Hürthle-like features are seen on aspiration biopsy of the thyroid.
我们报告一例具有透明细胞改变的滤泡性腺瘤，其在细针穿刺活检时酷似许特莱细胞肿瘤。巴氏染色涂片显示细胞呈单形性，松散聚集，胞质丰富，圆形核位于中央，有单个明显核仁。胞质呈颗粒状或有细小空泡，偶见胞质内棕色色素。随后部分甲状腺切除标本的手术组织学检查显示为一个由大滤泡和微滤泡组成的滤泡性腺瘤。微滤泡区域呈现透明细胞改变：这些细胞在细胞学上与所见细胞相同。手术标本中未出现许特莱细胞改变。当甲状腺穿刺活检发现具有许特莱样特征的细胞时，具有颗粒型透明细胞改变的滤泡细胞必须列入鉴别诊断清单。
