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具有显著浆细胞分化和淀粉样沉积的原发性甲状腺黏膜相关淋巴组织淋巴瘤的细胞学表现及鉴别诊断

Cytologic findings and differential diagnoses of primary thyroid MALT lymphoma with striking plasma cell differentiation and amyloid deposition.

作者信息

Nobuoka Yuri, Hirokawa Mitsuyoshi, Kuma Seiji, Takagi Nozomi, Higuchi Miyoko, Masuoka Hiroo, Miya Akihiro, Kubota Sumihisa, Miyauchi Akira

机构信息

Department of Clinical Laboratory, Kuma Hospital, Kobe, Hyogo, Japan.

出版信息

Diagn Cytopathol. 2014 Jan;42(1):73-7. doi: 10.1002/dc.23000. Epub 2013 May 2.

Abstract

We report two cases of thyroid mucosa-associated lymphoid tissue (MALT) lymphoma with associated amyloid protein deposition. While other primary thyroid neoplasms sush as medullary carcinoma and plasmacytoma with associated amyloid protein are known to occur and have been previously described by fine-needle aspiration cytology (FNAC), to our knowledge, the current cases are the first of thyroid MALT lymphoma with amyloid deposition to be detailed in the cytopathology literature. Case 1 was a 73-year-old female with chronic thyroiditis. FNAC suspected MALT lymphoma. The amyloid material was not noticed, nevertheless it existed. Case 2 was a 71-year-old female with a nodule of the thyroid. Malignant lymphoma and medullary carcinoma were suspected by FNAC. The possibility of medullary carcinoma was excluded by a measurement of serum calcitonin and carcinoembryonic antigen. After follow-up for two years, the nodule was diagnosed as MALT lymphoma associated with plasma cell differentiation and amyloidosis by the fourth FNAC. When we encounter small round cell tumors associated with amyloid in thyroid FNAC, we should consider not only medullary carcinoma but also MALT lymphoma.

摘要

我们报告了两例伴有淀粉样蛋白沉积的甲状腺黏膜相关淋巴组织(MALT)淋巴瘤。虽然其他原发性甲状腺肿瘤,如伴有淀粉样蛋白的髓样癌和浆细胞瘤已知会发生,并且先前已通过细针穿刺细胞学检查(FNAC)进行过描述,但据我们所知,目前这两例是甲状腺MALT淋巴瘤伴淀粉样沉积在细胞病理学文献中首次得到详细描述。病例1是一名73岁患有慢性甲状腺炎的女性。FNAC怀疑为MALT淋巴瘤。当时未注意到淀粉样物质,但它确实存在。病例2是一名71岁患有甲状腺结节的女性。FNAC怀疑为恶性淋巴瘤和髓样癌。通过检测血清降钙素和癌胚抗原排除了髓样癌的可能性。经过两年的随访,通过第四次FNAC,该结节被诊断为伴有浆细胞分化和淀粉样变性的MALT淋巴瘤。当我们在甲状腺FNAC中遇到伴有淀粉样蛋白的小圆形细胞肿瘤时,我们不仅应考虑髓样癌,还应考虑MALT淋巴瘤。

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