Kiran Tugce, Guler Beril
Department of Pathology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
Pol J Pathol. 2022;73(4):310-319. doi: 10.5114/pjp.2022.125778.
The nuclear features that are thought to be classic indicators of thyroid nodules are not fully observed in core needle biopsies (CNB). The aim of this study was to evaluate the histopathological differences between CNB samples and resection sections.
The haematoxylin and eosin-stained CNB and resection sections of thyroid nodules were retrospectively re-evaluated in terms of nuclear and architectural parameters. The evaluations were conducted by 2 pathologists. Statistical analysis was applied in 80 selected cases diagnosed as benign (n = 37) and papillary carcinoma/suspicious for papillary carcinoma (n = 43).
The nuclear findings in the CNB were more subtle than in the resection sections. The nuclei were smaller (measurements of the nuclear areas, major axes, and minor axes in CNB and resection sections were 52.62 µm2, 9.89 µm, 6.75 µm, 129.18 µm2, 14.53 µm, and 10.79 µm, respectively). Hypochromia was detected in 46.5% of the papillary carcinoma cases. Grooves and pseudoinclusions were the other nuclear features that could be detected. However, nuclear contour irregularity was the most reliable finding that could predict papillary carcinoma diagnosis in the CNB sections (v: 0.82, p < 0.001).
We believe that the histopathological differences we found have an important place in diagnostics and should be emphasized, and new diagnostic algorithms should be developed.
甲状腺结节的核特征被认为是经典的诊断指标,但在粗针穿刺活检(CNB)中并未完全观察到。本研究的目的是评估CNB样本与切除标本之间的组织病理学差异。
对甲状腺结节的苏木精-伊红染色的CNB样本和切除标本,就核参数和结构参数进行回顾性重新评估。评估由2名病理学家进行。对80例诊断为良性(n = 37)和乳头状癌/疑似乳头状癌(n = 43)的选定病例进行统计分析。
CNB中的核特征比切除标本中的更不明显。细胞核较小(CNB样本和切除标本中核面积、长轴和短轴的测量值分别为52.62 µm²、9.89 µm、6.75 µm、129.18 µm²、14.53 µm和10.79 µm)。在46.5%的乳头状癌病例中检测到核淡染。核沟和假包涵体是其他可检测到的核特征。然而,核轮廓不规则是CNB切片中预测乳头状癌诊断最可靠的发现(v:0.82,p < 0.001)。
我们认为我们发现的组织病理学差异在诊断中具有重要地位,应予以强调,并应开发新的诊断算法。