Zhao Huanyu, Lu Yudie, Zheng Jingrong, Xie Yuyao, Li Qingchang
Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning, China.
Department of Clinical Medicine, The First Clinical College of Jinzhou Medical University, Jinzhou, Liaoning, China.
Front Oncol. 2022 Nov 1;12:1038076. doi: 10.3389/fonc.2022.1038076. eCollection 2022.
Paraganglioma (PGL) is a neuroendocrine tumor that arises from the sympathetic or parasympathetic paraganglia. Primary thyroid PGL is extremely rare. PGL may be difficult to diagnose on frozen sections because its histopathological features, such as polygonal tumor cells with eosinophilic cytoplasm arranged irregularly, overlap with those of thyroid follicular adenoma. We present a case of thyroid PGL in a female patient and provide a detailed description of the patient's clinicopathologic characteristics. Cervical computed tomography showed a left thyroid mass with uneven density. Intraoperative frozen section analysis showed an uneven fibrous septa and rich networks of delicate vessels surrounding tumor cell nests. The tumor cells were polygonal or epithelioid with eosinophilic cytoplasm, arranged in a nest, trabecular, or organoid pattern were and diagnosed as thyroid follicular adenoma. However, in postoperative immunohistochemistry, these were diagnosed as thyroid PGL. The postoperative recovery was uneventful. The patient showed no signs of tumor recurrence or metastasis until 16 months of follow-up. Herein, we summarize the characteristic features of thyroid PGL based on frozen section analysis. In the appropriate clinical context, its proper use as diagnostic and differential diagnostic management strategies is recommended.
副神经节瘤（PGL）是一种起源于交感或副交感神经节的神经内分泌肿瘤。原发性甲状腺PGL极为罕见。PGL在冰冻切片上可能难以诊断，因为其组织病理学特征，如具有嗜酸性细胞质的多边形肿瘤细胞排列不规则，与甲状腺滤泡性腺瘤的特征重叠。我们报告一例女性甲状腺PGL病例，并详细描述患者的临床病理特征。颈部计算机断层扫描显示左侧甲状腺肿块，密度不均匀。术中冰冻切片分析显示纤维间隔不均匀，肿瘤细胞巢周围有丰富的细小血管网络。肿瘤细胞为多边形或上皮样，具有嗜酸性细胞质，呈巢状、小梁状或类器官样排列，被诊断为甲状腺滤泡性腺瘤。然而，术后免疫组化显示这些被诊断为甲状腺PGL。术后恢复顺利。在随访的16个月中，患者未出现肿瘤复发或转移迹象。在此，我们基于冰冻切片分析总结甲状腺PGL的特征。在适当的临床背景下，建议将其合理用作诊断和鉴别诊断管理策略。
