Molberg K, Albores-Saavedra J
Department of Pathology, University of Texas Southwestern Medical Center, Dallas 75235-9072.
Hum Pathol. 1994 Feb;25(2):192-7. doi: 10.1016/0046-8177(94)90277-1.
We report four unusual cases of hyalinizing trabecular thyroid tumors, three of which displayed capsular and/or blood vessel invasion and were classified as minimally invasive carcinomas. These three patients were all euthyroid women aged 18, 39, and 62 years. The youngest patient also had familial polyposis, while the oldest patient was being followed for Hashimoto's thyroiditis. All three lesions were solitary nodules, were "cold" by radioactive iodine thyroid scan, and ranged from 2.5 to 4.0 cm in diameter. The tumors were encapsulated and had growth patterns and cytologic features similar to those described for hyalinizing trabecular adenomas. In fact, the only difference between these minimally invasive hyalinizing trabecular carcinomas and the corresponding adenomas was the presence of capsular invasion in all three of the cases and vascular invasion in two. All three patients are free of recurrent or metastatic disease at 1 to 2 years' follow-up. The fourth patient, a 48-year-old woman, had a micropapillary carcinoma within a hyalinizing trabecular adenoma. She is also free of disease 5 years following excision of the involved lobe. These findings suggest that hyalinizing trabecular thyroid tumors have a malignant counterpart, similar to conventional follicular adenomas, and that papillary thyroid carcinomas may arise within hyalinizing trabecular thyroid tumors.
我们报告了4例罕见的透明变梁状甲状腺肿瘤，其中3例显示有包膜和/或血管侵犯，被归类为微侵袭癌。这3例患者均为甲状腺功能正常的女性，年龄分别为18岁、39岁和62岁。最年轻的患者还患有家族性息肉病，而最年长的患者因桥本甲状腺炎正在接受随访。所有3个病灶均为孤立性结节，放射性碘甲状腺扫描显示为“冷”结节，直径在2.5至4.0厘米之间。肿瘤有包膜，其生长方式和细胞学特征与描述的透明变梁状腺瘤相似。事实上，这些微侵袭性透明变梁状癌与相应腺瘤之间的唯一区别在于，所有3例均存在包膜侵犯，2例存在血管侵犯。所有3例患者在1至2年的随访中均无复发或转移疾病。第4例患者是一名48岁女性，在透明变梁状腺瘤内有微小乳头状癌。在切除受累叶5年后，她也未患疾病。这些发现表明，透明变梁状甲状腺肿瘤有恶性对应物，类似于传统的滤泡性腺瘤，并且甲状腺乳头状癌可能在透明变梁状甲状腺肿瘤内发生。
