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细针穿刺细胞学样本中转移性乳腺癌累及甲状旁腺腺瘤:一例报告

Metastatic breast carcinoma to parathyroid adenoma on fine needle cytology sample: report of a case.

作者信息

Fulciniti Franco, Pezzullo Luciano, Chiofalo Maria Grazia, Butera Daniela, Losito Nunzia Simona, Tommaselli Antonio Pasquale, Botti Gerardo

机构信息

S.S.D. di Citopatologia, A.F. di Anatomia Patologica, Istituto Nazionale Tumori "Fondazione G. Pascale" Naples, Italy.

出版信息

Diagn Cytopathol. 2011 Sep;39(9):681-5. doi: 10.1002/dc.21528. Epub 2010 Nov 28.

Abstract

Metastases to the thyroid gland diagnosed by means of fine needle cytology or by excision have been reported in the literature. To our knowledge, metastatic neoplasms to the parathyroid gland have never been described up to now. In this article, we introduce a rare case of metastatic breast carcinoma to a parathyroid adenoma in a 56-year-old woman, which clinically simulated a left thyroid nodule. The patient had a history of left breast carcinoma; the recent discovery of a palpable mass in the left thyroid area had elicited fine needle cytology sampling for its diagnostic evaluation. The obtained cytopathological sample was cellular but limited to a single Diff-Quik-stained smear; hence, no ancillary studies could be entertained. A cytopathological diagnosis of positive for malignant cells of query metastatic breast origin was performed. The permanent histopathological examination of the surgical sample disclosed multiple small foci of metastatic high-grade carcinoma of ductal type within a somewhat atypical adenoma of the parathyroid gland. The cytopathological findings and some differential diagnostic considerations are briefly commented, as well as the deranging imaging data concerning this interesting case.

摘要

文献中已有通过细针穿刺细胞学检查或手术切除诊断出甲状腺转移瘤的报道。据我们所知,迄今为止,尚未有关于甲状旁腺转移瘤的描述。在本文中,我们介绍了一例罕见的56岁女性甲状旁腺腺瘤发生乳腺转移癌的病例,临床上该病例表现为左侧甲状腺结节。患者有左侧乳腺癌病史;近期在左侧甲状腺区域发现可触及肿块,遂进行细针穿刺细胞学检查以评估诊断。所获得的细胞病理学样本有细胞成分,但仅限于一张Diff-Quik染色涂片;因此,无法进行辅助研究。做出了细胞病理学诊断,怀疑为转移性乳腺来源的恶性细胞阳性。手术样本的永久组织病理学检查显示,在一个 somewhat atypical 的甲状旁腺腺瘤内有多个小灶性转移性高级别导管癌。简要讨论了细胞病理学发现和一些鉴别诊断要点,以及有关此有趣病例的紊乱影像学数据。 (注:原文中“somewhat atypical”表述不太准确完整,推测可能是想表达“某种程度上不典型”之类意思,但按要求直接翻译)

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