Department of Cellular Pathology, University College London Hospitals NHS Foundation Trust, London, UK.
Diagn Cytopathol. 2021 Aug;49(8):E325-E328. doi: 10.1002/dc.24744. Epub 2021 Apr 1.
A 7-year-old girl presented with a painless neck swelling localised near the left lobe of the thyroid gland, which was initially investigated by fine needle aspiration cytology. This raised a differential diagnosis of medullary thyroid carcinoma and small round blue cell tumour. Only after several additional clinical investigations and a total thyroidectomy was a definitive diagnosis of spindle cell tumour with thymus-like differentiation (SETTLE) reached. This case report highlights how contemporaneous clinical and investigation findings made arriving at a definitive diagnosis challenging, contributed to diagnostic delay, and ultimately influenced choice of treatment.
一位 7 岁女孩出现无痛性颈部肿块，位于左叶甲状腺附近，最初通过细针穿刺细胞学检查进行了检查。这提出了甲状腺髓样癌和小圆蓝细胞肿瘤的鉴别诊断。只有经过几次额外的临床检查和全甲状腺切除术，才能明确诊断为具有胸腺样分化的梭形细胞肿瘤（SETTLE）。本病例报告强调了同时出现的临床和检查结果如何使明确诊断变得具有挑战性，导致诊断延迟，并最终影响治疗选择。
