Department of Pathology, The University of Chicago, Pritzker School of Medicine, 5841 South Maryland Avenue, MC 6101, Chicago, IL 60637, USA.
Department of Pathology, The University of Chicago, Pritzker School of Medicine, 5841 South Maryland Avenue, MC 6101, Chicago, IL 60637, USA.
Surg Pathol Clin. 2023 Mar;16(1):15-26. doi: 10.1016/j.path.2022.09.004. Epub 2022 Dec 10.
The use of intraoperative consultation for indeterminate thyroid lesions is not advocated but is still requested by some surgeons. Obscured cytomorphology and nonrepresentative sampling limit the specificity of intraoperative assessment. Formalin fixation of thyroid glands before sectioning also minimizes artifacts introduced by fresh sectioning. Inking of thyroid may vary based on institutional preferences and information desired by clinical teams. Sectioning may occur in the conventional transverse method or the modified transverse vertical method to more thoroughly evaluate the lesion's periphery. Gross examination of thyroid lesions should always consider possible high-grade features, such as necrosis or extrathyroidal extension.
对于不确定的甲状腺病变，不提倡使用术中咨询，但仍有一些外科医生要求使用。细胞形态学不明确和非代表性取样限制了术中评估的特异性。在切片之前对甲状腺进行福尔马林固定也最大限度地减少了新鲜切片引入的伪影。甲状腺的染色可能因机构偏好和临床团队所需的信息而异。切片可以以传统的横向方法或改良的横向垂直方法进行，以更彻底地评估病变的周边。甲状腺病变的大体检查应始终考虑可能的高级别特征，如坏死或甲状腺外延伸。
