Cipriani Nicole A
Department of Pathology, The University of Chicago, 5841 South Maryland Avenue, MC 6101, Chicago, IL 60637, USA.
Surg Pathol Clin. 2019 Dec;12(4):883-900. doi: 10.1016/j.path.2019.07.001. Epub 2019 Sep 18.
Differentiated thyroid carcinomas make up most thyroid malignancies. The AJCC staging system and the ATA risk prediction system are the best predictors of mortality and recurrence, respectively. Key factors to be identified and reported by pathologists are reviewed in this article and include: (1) aggressive histologic variants of papillary thyroid carcinoma (including tall cell, columnar cell, and hobnail variants); (2) presence of gross extrathyroidal extension (into skeletal muscle or adjacent organs); (3) angioinvasion (including number of foci); (4) number, anatomic level, and size of lymph node metastases; (4) extranodal extension; (5) genetics (especially BRAF V600E or TERT promoter mutation).
分化型甲状腺癌占大多数甲状腺恶性肿瘤。美国癌症联合委员会(AJCC)分期系统和美国甲状腺协会(ATA)风险预测系统分别是死亡率和复发的最佳预测指标。本文回顾了病理学家需要识别和报告的关键因素,包括:(1)甲状腺乳头状癌的侵袭性组织学变异型(包括高细胞、柱状细胞和鞋钉样变异型);(2)肉眼可见的甲状腺外侵犯(侵犯至骨骼肌或邻近器官);(3)血管侵犯(包括病灶数量);(4)淋巴结转移的数量、解剖水平和大小;(4)结外侵犯;(5)遗传学(尤其是BRAF V600E或TERT启动子突变)。