An Jungsuk, Oh Young Lyun, Shin Jung Hee, Jeong Han-Sin
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea.
Acta Cytol. 2010 Sep-Oct;54(5 Suppl):857-62.
Primary schwannomas of the thyroid gland are extremely rare. These tumors most often present as asymptomatic solitary neck masses, slow growing and rarely malignant. Only 15 cases of intrathyroidal schwannoma have been reported in the literature, and few have been reported with fine needle aspiration (FNA) cytology.
A 14-year-old male patient presented with an asymptomatic left intrathyroidal mass. Radiologic studies revealed a circumscribed, marked hypoechoic mass with cystic portions in the left lobe of the thyroid gland on ultrasonography, pushing the trachea toward the right, visible side on computed tomography. FNA cytology of the mass exhibited a paucicellular smear composed of predominantly round to oval-shaped cells and occasional ovoid to spindle-shaped cells in loosely cohesive aggregates. On pathologic examination, the mass measured 60 x 45 x 30 mm and consisted of spindle-shaped cells arranged in fascicles in a whorling pattern in association with alternating hypercellular and hypocellular areas.
Awareness of and understanding of the cytopathologic and radiologic characteristics of this entity are helpful in preoperative evaluation and correct treatment of intrathyroidal schwannoma.
甲状腺原发性神经鞘瘤极为罕见。这些肿瘤最常表现为无症状的孤立性颈部肿块,生长缓慢,很少恶变。文献中仅报道了15例甲状腺内神经鞘瘤,经细针穿刺(FNA)细胞学检查报道的病例较少。
一名14岁男性患者,出现无症状的左侧甲状腺内肿块。影像学检查显示,超声检查发现甲状腺左叶有一个边界清晰、显著低回声的肿块,伴有囊性部分,将气管推向右侧,计算机断层扫描可见。肿块的FNA细胞学检查显示涂片细胞少,主要由圆形至椭圆形细胞组成,偶尔有卵形至梭形细胞,呈松散聚集。病理检查显示,肿块大小为60×45×30mm,由梭形细胞组成,呈束状排列,呈漩涡状,伴有细胞增多和细胞减少交替的区域。
认识和了解该实体的细胞病理学和放射学特征有助于甲状腺内神经鞘瘤的术前评估和正确治疗。