Kholová Ivana
Pathology, Fimlab Laboratories, Tampere University Hospital, Tampere, Finland.
Diagn Cytopathol. 2016 Jul;44(7):568-73. doi: 10.1002/dc.23479. Epub 2016 Apr 20.
Fine-needle aspiration (FNA)-induced secondary changes were described in various organs. Complete replacement of tumor by necrosis causes diagnostic and management problems.
Seven cases of totally or partially vanished thyroid lesions were identified from the archive of Department of Pathology, Fimlab Laboratories within 5 year period. Histopathological slides were revised in all cases.
Total thyroidectomy or lobectomy samples were from 4 females and 3 males patients aged 37-83 years (mean 67.1 years). Imaging data were available in 6 cases. Cytology slides and data were available only in 3 cases: two revealed follicular neoplasm and one was insufficient according to Bethesda system. In 5 cases, final histopathology revealed total necrosis of the lesion with only one case with available cytological diagnosis of oncocytic follicular neoplasm. In remaining 2 cases, replacement by necrosis was partial. Of note, in three cases, oncocytic metaplasia was present.
Total histopathological blocking with thorough check of capsular areas is recommended in necrotic tumors. Vanishing thyroid lesion phenomenon is rare, but in cases of disappearance of tumor, preoperative cytology diagnosis is the only clue for the patient management. Diagn. Cytopathol. 2016;44:568-573. © 2016 Wiley Periodicals, Inc.
细针穿刺（FNA）引起的继发性改变在各个器官中均有描述。肿瘤完全被坏死组织替代会导致诊断和治疗问题。
在5年期间内，从Fimlab实验室病理科档案中识别出7例甲状腺病变完全或部分消失的病例。对所有病例的组织病理学切片进行复查。
甲状腺全切除术或叶切除术样本来自4名女性和3名男性患者，年龄37 - 83岁（平均67.1岁）。6例有影像学资料。仅3例有细胞学切片和数据：2例显示滤泡性肿瘤，1例根据贝塞斯达系统诊断不足。5例最终组织病理学显示病变完全坏死，仅1例有嗜酸细胞性滤泡性肿瘤的细胞学诊断。其余2例坏死替代为部分性。值得注意的是，3例存在嗜酸细胞化生。
对于坏死性肿瘤，建议进行全面的组织病理学检查并仔细检查包膜区域。甲状腺病变消失现象罕见，但在肿瘤消失的病例中，术前细胞学诊断是患者管理的唯一线索。诊断细胞病理学。2016；44：568 - 573。©2016威利期刊公司。
