Samiee-Rad Fatemeh, Farajee Sohayla, Torabi Erfan
Department of Pathology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
Medical Student, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
Iran J Pathol. 2019 Fall;14(4):342-346. doi: 10.30699/ijp.2019.99544.1986. Epub 2019 Sep 22.
The most usual form of the endocrine carcinoma is thyroid cancer (TC). In addition to papillary thyroid carcinoma (PTC), recent studies revealed incidence of RET/PTC rearrangement in other tumors, like Hürthle cell carcinoma (HCC) and even in non-carcinomatous disorders like Hashimoto's thyroiditis. Here, we present a case with concurrence of papillary thyroid carcinoma and Hürthle cell carcinoma. A 60-year-old woman referred to our hospital with a mass in her neck. Physical examinations revealed painful swelling in the thyroid. Ultrasonographic examination showed two hypoechoic nodules in the right lobe. Hürthle cell variant papillary carcinoma was suggested in the cytology report of the fine needle aspiration. Permanent histopathological diagnosis was co-existence of papillary thyroid carcinoma and Hürthle cell carcinoma. The patient was asymptomatic in 14 months follow up. Concurrence of papillary carcinoma and Hürthle cell carcinoma is a rare form of thyroid malignancies, with doubtful cytogenetic findings and biological behaviors. The results showed that it is necessary for the surgeons and pathologists to be aware of lesions for the optimal diagnostic and therapeutic interventions. Also, it is vital to follow up patients with the Hashimot's thyroiditis who have multiple nodules to detect occult thyroid cancers and decide for better therapeutic programs.
内分泌癌最常见的形式是甲状腺癌（TC）。除了乳头状甲状腺癌（PTC）外，最近的研究还揭示了RET/PTC重排在其他肿瘤中的发生率，如嗜酸性细胞癌（HCC），甚至在非癌性疾病如桥本甲状腺炎中也有发现。在此，我们报告一例乳头状甲状腺癌和嗜酸性细胞癌同时存在的病例。一名60岁女性因颈部肿物转诊至我院。体格检查发现甲状腺有压痛性肿胀。超声检查显示右叶有两个低回声结节。细针穿刺细胞学报告提示为嗜酸性细胞变异型乳头状癌。最终组织病理学诊断为乳头状甲状腺癌和嗜酸性细胞癌并存。患者在14个月的随访中无症状。乳头状癌和嗜酸性细胞癌并存是甲状腺恶性肿瘤的一种罕见形式，其细胞遗传学表现和生物学行为尚不明确。结果表明，外科医生和病理学家有必要了解这些病变，以便进行最佳的诊断和治疗干预。此外，对患有多个结节的桥本甲状腺炎患者进行随访，以检测隐匿性甲状腺癌并确定更好的治疗方案也至关重要。
