Institute of Molecular Pathology and Immunology, University of Porto (IPATIMUP), Porto, Portugal.
Mod Pathol. 2011 Apr;24 Suppl 2:S10-8. doi: 10.1038/modpathol.2010.133.
Follicular thyroid carcinoma is being diagnosed less and less frequently despite the increasing incidence of well-differentiated thyroid carcinomas everywhere. This review will discuss the reasons underlying such an observation focusing on the evolution of the morphological and immunohistochemical diagnostic criteria of follicular thyroid tumors. It will address the differential diagnosis between follicular carcinoma and three tumor types--follicular adenoma, follicular variant of papillary carcinoma and poorly differentiated carcinoma--as well as the problems raised by the newly described categories of follicular tumors: follicular tumor of uncertain malignant potential, well-differentiated tumor of uncertain malignant potential and well-differentiated carcinoma, not otherwise specified. Finally, the prognostic and therapeutic significance of some promising molecular biomarkers will be discussed within the frame of the aforementioned histopathological classification.
滤泡性甲状腺癌的诊断频率越来越低,尽管世界各地分化良好的甲状腺癌的发病率都在上升。本综述将讨论这种观察结果的原因,重点是滤泡性甲状腺肿瘤形态和免疫组织化学诊断标准的演变。它将解决滤泡状癌与三种肿瘤类型(滤泡性腺瘤、滤泡状甲状腺癌的滤泡型变体和低分化癌)之间的鉴别诊断,以及新描述的滤泡性肿瘤类别所带来的问题:恶性潜能不确定的滤泡性肿瘤、恶性潜能不确定的分化良好的肿瘤和未特指的分化良好的癌。最后,将在上述组织病理学分类的框架内讨论一些有前途的分子生物标志物的预后和治疗意义。