Division of Anatomic Pathology and Histology, Catholic University of Sacred Heart, Rome, Italy.
Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Cancer Cytopathol. 2019 Jul;127(7):432-446. doi: 10.1002/cncy.22136. Epub 2019 May 31.
Certain carcinomas of the thyroid gland behave aggressively resulting in increased patient morbidity and poor patient prognosis. The diagnosis of these aggressive thyroid cancer subtypes is sometimes challenging and subject to increased interobserver variability. This review deals with the cytological features of such tumors including aggressive variants of papillary thyroid carcinoma, poorly differentiated thyroid carcinoma, and anaplastic thyroid carcinoma. These malignancies fall into 2 groups based on their cytomorphology: those that exhibit distinct microscopic features (eg, nuclear findings typical of classical papillary thyroid carcinoma or marked anaplasia) and those that present with more subtle cytologic features (eg, nuclear pseudostratification, "soap bubble" nuclei, supranuclear or subnuclear cytoplasmic vacuoles, rosette-like structures, hobnail cells). We review the literature regarding these aggressive thyroid cancers and highlight important phenotypic characteristics that can be useful for their diagnosis based on fine needle aspiration.
某些甲状腺腺癌具有侵袭性，导致患者发病率增加和预后不良。这些侵袭性甲状腺癌亚型的诊断有时具有挑战性，并且观察者间的变异性增加。这篇综述涉及这些肿瘤的细胞学特征，包括侵袭性甲状腺乳头状癌、低分化甲状腺癌和间变性甲状腺癌的变异型。这些恶性肿瘤根据其细胞学形态分为 2 组：那些表现出明显微观特征的肿瘤（例如，具有经典甲状腺乳头状癌或明显间变的核特征）和那些表现出更微妙细胞学特征的肿瘤（例如，核假复层、“肥皂泡”核、核上或核下细胞质空泡、玫瑰花结样结构、钉状细胞）。我们回顾了关于这些侵袭性甲状腺癌的文献，并强调了基于细针抽吸的有用的重要表型特征。
