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甲状腺颗粒细胞瘤:一名14岁女孩罕见病例的临床及病理特征

Granular cell tumor of the thyroid: Clinical and pathological characteristics of a rare case in a 14-year-old girl.

作者信息

DU Zhen-Hong, Qiu Hong-Yan, Wei Tao, Zhu Jing-Qiang

机构信息

Department of Gastrointestinal and Thoracic Surgery, 363 Hospital, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, P.R. China.

Department of Infectious Disease, 416 Hospital, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, P.R. China.

出版信息

Oncol Lett. 2015 Feb;9(2):777-779. doi: 10.3892/ol.2014.2775. Epub 2014 Dec 8.

Abstract

Granular cell tumors (GCTs) are soft tissue neoplasms that originate in the nervous system, which may arise anywhere in the body. However, GCTs are extremely uncommon in thyroid tumors, with a favorable prognosis. The diagnosis of GCTs is dependent on pathological and immunohistochemical analysis and at present, surgical resection is considered the only suitable treatment. Regular follow-up after surgery is an important way to monitor treatment outcome and recurrence. The present study describes a new pathological type of thyroid GCTs diagnosed by pathology and immunohistochemistry. A 14-year-old female was referred to the West China Hospital of Sichuan University (Chengdu, China), for thyroid incidentaloma. Laboratory examinations were within the normal range. Thyroid sonography demonstrated a solid hypoechoic mass in the right lobe of the thyroid. Fine needle aspiration cytology showed a suspicious malignant tumor and subsequently a total thyroidectomy was performed. Analysis of frozen sections, from obtained samples, did not facilitate a definite diagnosis. Finally, a thyroid benign granular tumor with atypical changes was diagnosed by postoperative pathology and immunohistochemistry. A 14-month post-operative follow-up showed that the patient experienced a stable recovery and had no signs of recurrence or metastasis. The case emphasizes that the diagnosis of thyroid granular cell tumors is predominantly based on postoperative morphology and immunophenotype. The clinical routine for the differential diagnosis may be due to: (i) neoplasms displaying a granular appearance mimicking granular cell tumors, or (ii) differential diagnosis in the pathological category of granular cell tumors. Further accumulation of such rare cases may be of clinical significance in aiding the diagnosis and treatment of GCTs.

摘要

颗粒细胞瘤(GCTs)是起源于神经系统的软组织肿瘤,可发生于身体的任何部位。然而,GCTs在甲状腺肿瘤中极为罕见,预后良好。GCTs的诊断依赖于病理和免疫组化分析,目前,手术切除被认为是唯一合适的治疗方法。术后定期随访是监测治疗效果和复发情况的重要方式。本研究描述了一种通过病理和免疫组化诊断的甲状腺GCTs新病理类型。一名14岁女性因甲状腺偶发瘤转诊至四川大学华西医院(中国成都)。实验室检查结果在正常范围内。甲状腺超声显示甲状腺右叶有一个实性低回声肿块。细针穿刺细胞学检查显示为可疑恶性肿瘤,随后进行了甲状腺全切除术。对获取样本的冰冻切片分析未能明确诊断。最终,通过术后病理和免疫组化诊断为伴有非典型改变的甲状腺良性颗粒细胞瘤。术后14个月的随访显示患者恢复稳定,无复发或转移迹象。该病例强调甲状腺颗粒细胞瘤的诊断主要基于术后形态学和免疫表型。临床鉴别诊断的常规情况可能是:(i)肿瘤呈现类似颗粒细胞瘤的颗粒外观,或(ii)颗粒细胞瘤病理类别中的鉴别诊断。此类罕见病例的进一步积累可能对GCTs的诊断和治疗具有临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c99/4301563/965ea2951d74/OL-09-02-0777-g00.jpg

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