Muthalagan Elancheran, Subashchandrabose Priya, Sivasubramanian Priya Banthavi, Venkateswaran Sarada
Department of Pathology, Chennai Medical College Hospital and Research Centre, Thiruchirapalli, Tamil Nadu, India.
J Cytol. 2015 Oct-Dec;32(4):278-80. doi: 10.4103/0970-9371.171252.
Papillary thyroid carcinoma (PTC) is the most common malignant neoplasm of the thyroid. On fine-needle aspiration (FNA) cytology smears of conventional PTC, the background usually shows scanty, bubble gum-like colloid. But the macrofollicular variant and papillary microcarcinoma reveals abundant thin colloid in the background. We report a case of papillary carcinoma of thyroid in a 37-year-old female with abundant thin colloid, obscuring the nuclear morphology in many clusters, along with the presence of typical nuclear features within occasional clusters in FNA cytology and hence, masquerading as colloid goiter with papillary hyperplasia. Histopathological examination of the total thyroidectomy specimen revealed papillary microcarcinomatous focus in a background of nodular hyperplasia. The differential diagnosis of PTC should be entertained even in colloid-rich FNA smears if the typical nuclear features are present. Hence, a meticulous search for any fragment with nuclear features of PTC is mandatory before labeling the smears as benign nodular hyperplasia.
甲状腺乳头状癌（PTC）是甲状腺最常见的恶性肿瘤。在传统PTC的细针穿刺（FNA）细胞学涂片上，背景通常显示少量、泡泡糖样的胶质。但巨滤泡型变体和甲状腺微小癌在背景中显示丰富的稀薄胶质。我们报告一例37岁女性甲状腺乳头状癌，其FNA细胞学检查显示背景中有丰富的稀薄胶质，许多细胞团中的核形态模糊不清，偶尔有细胞团内存在典型核特征，因此伪装成伴有乳头状增生的胶样甲状腺肿。全甲状腺切除标本的组织病理学检查显示在结节性增生背景中有甲状腺微小癌灶。即使在富含胶质的FNA涂片上，如果存在典型核特征，也应考虑PTC的鉴别诊断。因此，在将涂片标记为良性结节性增生之前，必须仔细寻找任何具有PTC核特征的碎片。
