Kim Yeun Jeong, Hong Hyun Sook, Jeong Sun Hye, Lee Eun Hye, Kwak Jeong Ja
Departments of *Radiology and †Pathology, Soonchunhyang University, Bucheon Hospital, Bucheon, Republic of Korea.
Ultrasound Q. 2017 Mar;33(1):62-65. doi: 10.1097/RUQ.0000000000000235.
Papillary thyroid carcinoma (PTC) arising within a follicular adenoma is an exceptionally rare histopathological subtype that shows the nuclear features of PTC within a benign-appearing, circumscribed follicular adenoma. Although it is clinically significant because of its malignant nature, its ultrasonographic features have not been described previously. A 26-year-old man presented with a heterogeneous isoechoic solid nodule with a marked hypoechoic solid focus and a low echoic peripheral rim in the right thyroid gland on ultrasonography. On color Doppler images, markedly increased vascularity was seen in the hypoechoic solid component. An ultrasound-guided gun biopsy suggested a follicular neoplasm. In the evaluation of a hemithyroidectomy specimen, thyroid follicles and a thin fibrous capsule were seen, which favored a follicular adenoma with tumor cells in a focal area indicating papillary carcinoma. Here, we report a case of PTC arising within a follicular adenoma and discuss possible considerations in thyroid ultrasonographic examinations.
滤泡性腺瘤内发生的乳头状甲状腺癌（PTC）是一种极其罕见的组织病理学亚型，在外观良性、边界清楚的滤泡性腺瘤内表现出PTC的核特征。尽管因其恶性性质具有临床意义，但其超声特征此前尚未见描述。一名26岁男性超声检查显示右侧甲状腺有一个不均匀等回声实性结节，伴有明显的低回声实性灶和低回声周边环。在彩色多普勒图像上，低回声实性成分中可见血管明显增多。超声引导下穿刺活检提示为滤泡性肿瘤。在对甲状腺半切标本的评估中，可见甲状腺滤泡和薄纤维包膜，提示为滤泡性腺瘤，局部区域的肿瘤细胞提示为乳头状癌。在此，我们报告一例滤泡性腺瘤内发生的PTC病例，并讨论甲状腺超声检查中可能的注意事项。
