Department of Pathology, Yichang Central People's Hospital, Institute of Pathology of China Three Gorges University, Yichang, Hubei Province, China.
Indian J Pathol Microbiol. 2024 Jan-Mar;67(1):128-132. doi: 10.4103/ijpm.ijpm_405_22.
The incidence of thyroid tumor is increasing, and preoperative diagnosis of hyalinizing trabecular tumor (HTT) is difficult.
To investigate the cytological features of HTT of the thyroid gland.
A retrospective observational study.
Ultrasonography, preoperative needle aspiration cytology, postoperative histopathology, immunohistochemistry, and BRAF V600E gene test were performed in five patients with HTT to analyze the pathological characteristics of the patients and review the relevant literature.
Four female and one male patients with HTT were recruited. Fine-needle aspiration cytology (FNAC) showed bloodstained background tumor cells with multiple morphologies. The tumor cells exhibited ovoid nuclei, abundant cytoplasm, fine chromatin, nuclear crowding and overlapping, and small nucleoli. Focal nuclear pseudoinclusions and grooves were present. No papillary structures or psammoma bodies were observed. In all cases, tumor cells were radially distributed around the eosinophilic extracellular matrix. In 40% (2 in 5) of cases, trabecular patterns of elongated tumor cells were present, with their nuclei staggered along the longitudinal axis of tumor cells in the trabeculae. FNAC suggested two cases of HTT and three cases of papillary thyroid cancer. Post-operational biopsy indicated they were HTT cases.
HTT is a rare thyroid tumor with non-specific clinical manifestations. It can be misinterpreted as papillary thyroid carcinoma by FNAC. However, its cytomorphological traits are helpful in the diagnosis. In combination with FNAC, immunohistochemistry, and molecular testing, HTT can be accurately diagnosed.
甲状腺肿瘤的发病率正在增加，且其术前诊断较为困难。
探讨甲状腺透明细胞小梁肿瘤（HTT）的细胞学特征。
回顾性观察性研究。
对 5 例 HTT 患者进行超声、术前细针抽吸细胞学、术后组织病理学、免疫组织化学和 BRAF V600E 基因检测，分析患者的病理特征并复习相关文献。
共纳入 4 例女性和 1 例男性 HTT 患者。细针抽吸细胞学（FNAC）显示血性背景下肿瘤细胞形态多样。肿瘤细胞呈卵圆形核，细胞质丰富，染色质细腻，核拥挤、重叠，核小。可见局灶性核假包涵体和核沟。未见乳头结构或砂粒体。所有病例均可见肿瘤细胞围绕嗜酸性细胞外基质呈放射状分布。40%（5 例中有 2 例）的病例存在长形肿瘤细胞小梁状模式，小梁内的细胞核沿着肿瘤细胞的纵轴交错排列。FNAC 提示 2 例 HTT 和 3 例甲状腺乳头状癌。术后活检提示均为 HTT 病例。
HTT 是一种罕见的甲状腺肿瘤，临床表现无特异性。FNAC 可能误诊为甲状腺乳头状癌。然而，其细胞学特征有助于诊断。结合 FNAC、免疫组织化学和分子检测，可准确诊断 HTT。
