Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cancer Cytopathol. 2022 Jan;130(1):72-79. doi: 10.1002/cncy.22511. Epub 2021 Sep 16.
Thyroglossal duct cysts (TGDCs) are the most common congenital midline cystic lesions in the neck, and they are often evaluated by fine-needle aspiration. Recognizing the cytomorphologic features of TGDCs and their mimics is important for clinical management.
This study examined the clinical, radiological, and cytopathological features of 86 ultrasonography-guided fine-needle aspiration (US-FNA) specimens from clinically suspected TGDCs or malignancies arising from TGDCs and correlated the findings with surgical follow-up and/or imaging studies.
According to ultrasound examinations of 66 lesions, 17 (25.8%) were cystic, 8 (12.1%) were cystic with septations, 21 (31.8%) were cystic with solid nodules, and 20 (30.3%) were solid or cystic with internal debris. Cytopathologically, 81 lesions (94%) were categorized as benign, 2 (2%) were categorized as atypical, and 3 (3%) were categorized as malignant. In benign lesions, proteinaceous material (63%), histiocytes (63%), colloid (37%), squamous cells (35%), columnar cells (32%), follicular cells (15%), inflammatory cells (9%), and multinucleated giant cells (9%) were noted. Diagnoses in the benign category included TGDC in 64 patients (75%), TGDC or mimics (colloid nodule/epidermoid cyst) in 14 patients (17%), a colloid nodule in 1 patient, and thyroiditis in 1 patient. Surgical resection, performed in 23 patients, confirmed TGDCs in 12, benign mimics in 7, and carcinoma in 4.
Cytopathological features, in conjunction with imaging, allowed a definite diagnosis of TGDC in most patients (75%). The presence of mature squamous cells, thyroid follicular cells, with or without colloid and/or lymphocytes alone allowed a differential diagnosis of TGDC and its mimics in 17%. US-FNA findings could not distinguish primary carcinomas arising from TGDCs from metastatic tumors.
甲状舌管囊肿（TGDC）是颈部最常见的先天性中线囊性病变，通常通过细针抽吸进行评估。识别 TGDC 及其类似物的细胞形态学特征对于临床管理很重要。
本研究检查了 86 例经临床怀疑为 TGDC 或源自 TGDC 的恶性肿瘤的超声引导下细针抽吸（US-FNA）标本的临床、影像学和细胞学特征，并将这些发现与手术随访和/或影像学研究相关联。
根据 66 个病变的超声检查，17 个（25.8%）为囊性，8 个（12.1%）为囊性伴分隔，21 个（31.8%）为囊性伴实性结节，20 个（30.3%）为实性或囊性伴内部碎片。细胞学上，81 个病变（94%）归类为良性，2 个（2%）归类为非典型，3 个（3%）归类为恶性。在良性病变中，观察到蛋白物质（63%）、组织细胞（63%）、胶体（37%）、鳞状细胞（35%）、柱状细胞（32%）、滤泡细胞（15%）、炎症细胞（9%）和多核巨细胞（9%）。在良性病变中，64 例患者（75%）诊断为 TGDC，14 例患者（17%）诊断为 TGDC 或类似物（胶体结节/表皮样囊肿），1 例患者诊断为胶体结节，1 例患者诊断为甲状腺炎。在 23 例患者中进行了手术切除，12 例证实为 TGDC，7 例证实为良性类似物，4 例证实为癌。
细胞学特征结合影像学检查可使大多数患者（75%）明确诊断为 TGDC。单纯存在成熟的鳞状细胞、甲状腺滤泡细胞，伴有或不伴有胶体和/或淋巴细胞，可使 17%的患者能够鉴别 TGDC 及其类似物。US-FNA 结果无法区分源自 TGDC 的原发性癌与转移性肿瘤。
