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包裹性滤泡型乳头状甲状腺癌:组织学诊断中的问题

Encapsulated follicular variant papillary thyroid carcinoma: problems in histological diagnosis.

作者信息

Boler Anup, Chattopadhyay Sarbani, Mallick Jayati, Biswas Soumitra, Maiti Moumita

机构信息

Department of Pathology, NRS Medical College, Kolkata 700014.

出版信息

J Indian Med Assoc. 2012 Aug;110(8):536-40.

Abstract

Thyroid neoplasms are the commonest endocrine neoplasms and account for the most number of thyroidectomies done. Encapsulated thyroid lesions are being encountered more commonly in thyroidectomy specimens in recent time. The present study was undertaken to analyse the incidence of thyroid malignancies with a changing pattern and to discuss the difficulties encountered in histopathological interpretation of encapsulated neoplastic lesions of follicular cell origin. It is a retrospective study done in the department of pathology, NRS Medical College, Kolkata. Data of all the thyroidectomy specimens examined over last four years (August 2006 to July 2010) were retrieved and slides were reviewed. All slides of thyroid lesion received in the department of pathology, NRS Medical College for review were also included in this study. Frequency distribution study was done with the sample analysed. Follicular variant of papillary carcinoma was the commonest type of thyroid malignancy, on review, with the encapsulated sub-variant exceeding the diffuse type. This variant is a diagnostic challenge because it has to be differentiated from other encapsulated follicular thyroid lesions, especially follicular adenoma. The data analysis, results and problems in the diagnostic protocols are discussed in this study along with review of literature. Reclassification of thyroid tumour may be warranted in future with this background.

摘要

甲状腺肿瘤是最常见的内分泌肿瘤,也是甲状腺切除术数量最多的原因。近年来,在甲状腺切除标本中,包膜性甲状腺病变越来越常见。本研究旨在分析甲状腺恶性肿瘤发病率的变化模式,并探讨在滤泡细胞来源的包膜性肿瘤性病变的组织病理学解读中遇到的困难。这是一项在加尔各答NRS医学院病理科进行的回顾性研究。检索了过去四年(2006年8月至2010年7月)所有接受检查的甲状腺切除标本的数据,并对切片进行了复查。NRS医学院病理科接收的所有用于复查的甲状腺病变切片也纳入了本研究。对分析的样本进行了频率分布研究。回顾发现,乳头状癌的滤泡变体是最常见的甲状腺恶性肿瘤类型,其中包膜性亚型超过弥漫型。这种变体是一个诊断挑战,因为它必须与其他包膜性滤泡性甲状腺病变,尤其是滤泡性腺瘤相鉴别。本研究结合文献复习,讨论了诊断方案中的数据分析、结果及问题。在此背景下,未来可能有必要对甲状腺肿瘤进行重新分类。

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