Department of Pathology, Jeonbuk National University Medical School, Jeonbuk National University Medical School, 567 Baekje-daero, Doekjin-gu, Jeonju-si, Jeollabuk-do, 561-756, Republic of Korea.
Division of Breast Thyroid Surgery, Department of Surgery, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
Diagn Pathol. 2021 Mar 17;16(1):25. doi: 10.1186/s13000-021-01087-2.
Fine-needle aspiration (FNA) is a frequently utilized method for the diagnosis of thyroid nodules. Although the technique has clear advantages, the injury caused by the aspiration needle can induce various histological alterations. Herein, we report a case of follicular adenoma showing histological alterations possibly caused by FNA biopsy. Furthermore, the histological appearance of the lesion mimicked those of medullary thyroid carcinoma, particularly in the frozen section.
Ultrasonography of a thyroid nodule in a 39-year-old man revealed a mass (2.2 cm in diameter) in the right thyroid lobe. FNA was performed three times on the mass, and the results of the cytology were atypia of undetermined significance. Thereafter, the patient underwent right hemithyroidectomy. The histological findings of the operative frozen section analysis indicated medullary thyroid carcinoma. However, after evaluation and immunohistochemical staining of the permanent section, the mass was diagnosed as follicular adenoma with extensive fibrosis.
The histological alterations observed in the follicular adenoma are believed to have been caused by injury during the repeated FNA procedures.
细针穿刺（FNA）是诊断甲状腺结节的常用方法。虽然该技术具有明显的优势，但抽吸针造成的损伤可诱导各种组织学改变。在此，我们报告一例滤泡性腺瘤病例，其组织学改变可能由 FNA 活检引起。此外，病变的组织学表现类似于甲状腺髓样癌，尤其是在冷冻切片中。
一名 39 岁男性的甲状腺结节超声检查显示右甲状腺叶有一个肿块（直径 2.2cm）。对该肿块进行了 3 次 FNA，细胞学检查结果为意义未明的不典型性。此后，患者接受了右甲状腺叶切除术。手术冷冻切片分析的组织学结果提示甲状腺髓样癌。然而，在对石蜡切片进行评估和免疫组织化学染色后，该肿块被诊断为广泛纤维化的滤泡性腺瘤。
滤泡性腺瘤中观察到的组织学改变被认为是由反复 FNA 过程中的损伤引起的。
