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甲状腺乳头状癌筛状-柱状细胞变异型:超声及临床特征。

Cribriform-morular variant of papillary thyroid carcinoma: ultrasonographic and clinical characteristics.

机构信息

Department of Radiology, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Thyroid. 2013 Jan;23(1):45-9. doi: 10.1089/thy.2011.0534. Epub 2012 Aug 14.

Abstract

BACKGROUND

The cribriform-morular variant of papillary thyroid carcinoma (cmvPTC) is rare. There are few if any studies of the ultrasonographic (US) features of cmvPTC. The aim of this study was to determine the characteristic US and clinical features of the cmvPTC.

METHODS

A retrospective review of the US and clinical features was performed on 18 surgically confirmed cmvPTCs in five patients who were seen at our institution between January 2000 and December 2010.

RESULTS

All patients were female with a mean age of 28 years (range, 19-46 years). Two patients presented with palpable lesions, and the other patients were incidentally detected during screening US. On US, the majority of nodules had well-defined, oval to round shapes, and were hypoechoic and solid without calcifications. However, 6 (33.3%) of 18 nodules did have a cystic change. The size of the lesions varied from 0.3 to 3.0 cm (mean, 1.11 cm). None of the nodules were diagnosed as malignant based on the US criteria, but all except one patient had a cytology of their thyroid nodules that was read as malignant, without revealing the subtype of their PTC. Two of the five patients had familial adenomatous polyposis (FAP), and they had bilateral multiple nodules. No metastatic lymph nodes or extrathyroidal extension were identified. To date, none of the patients has had recurrence or metastasis during their mean follow-up of 25 months after thyroidectomy.

CONCLUSION

It appears that most cases of cmvPTC do not have features of malignancy on US and that they are indolent tumors as far as their clinical and histological features are concerned.

摘要

背景

筛状-条索状甲状腺乳头状癌(cmvPTC)较为罕见。目前,有关 cmvPTC 的超声(US)特征的研究甚少。本研究旨在探讨 cmvPTC 的特征性 US 和临床特征。

方法

回顾性分析 2000 年 1 月至 2010 年 12 月在我院就诊的 5 例 5 名经手术证实为 cmvPTC 患者的 US 和临床特征。

结果

所有患者均为女性,平均年龄 28 岁(1946 岁)。2 例患者因触及包块就诊,其余 3 例患者为筛查 US 时偶然发现。US 显示,大多数结节形态为边界清楚的椭圆形或类圆形,呈低回声,实性,无钙化。但 18 个结节中,有 6 个(33.3%)存在囊性变。病变大小为 0.33.0cm(平均 1.11cm)。根据 US 标准,没有一个结节被诊断为恶性,但除 1 例患者外,其余患者的甲状腺结节细胞学检查均提示为恶性,而未明确其 PTC 的亚型。5 例患者中有 2 例为家族性腺瘤性息肉病(FAP),且均为双侧多发结节。未发现淋巴结转移或甲状腺外侵犯。截至目前,所有患者在甲状腺切除术后的平均 25 个月随访期间均无复发或转移。

结论

cmvPTC 似乎在 US 上没有表现出恶性特征,就其临床和组织学特征而言,属于惰性肿瘤。

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