Vodanovic S, Crepinko I, Smoje J
Department of Nuclear Medicine and Thyroid Diseases, Osijek General Hospital and Clinical Center Rebro, Zagreb, Croatia.
Acta Cytol. 1993 May-Jun;37(3):317-22.
Despite difficulties in differential diagnosis, aspiration cytology offers unique advantages in the preoperative diagnosis of Hürthle cell (HC) tumors of the thyroid gland over immunocytochemistry and micromorphometry, which have not achieved the anticipated success in the diagnosis of HC tumors. Aspiration cytology is comparable, in terms of speed and accuracy, to microspectrometry of DNA content in HC tumors, a technique that is not convenient for routine use. Detailed morphologic analysis of 19 characteristics of the smears and of the cells revealed five parameters adding to the sensitivity, specificity and reliability of routine diagnosis: HC collection in the form of nests, marked or at least moderate anisocytosis and anisokaryosis, multinucleation and emphasized nucleoli. All five criteria are found in > 70% of HC tumors, and the rate of false positives is < 50%. The simultaneous presence of three or four of these five parameters occurred in 70-90% of HC tumors and would lead to a false-positive diagnosis of HC tumors in only 30% of cases. Routine cytologic diagnosis of HC tumors of the thyroid gland may be improved by adoption of these criteria.
尽管鉴别诊断存在困难，但与免疫细胞化学和微观形态测量法相比，细针穿刺细胞学检查在甲状腺嗜酸性细胞（HC）肿瘤的术前诊断中具有独特优势，后两者在HC肿瘤诊断中并未取得预期成功。在速度和准确性方面，细针穿刺细胞学检查与HC肿瘤DNA含量的微量光谱测定法相当，而后者并不便于常规使用。对涂片和细胞的19项特征进行详细形态学分析后发现，有五个参数可提高常规诊断的敏感性、特异性和可靠性：细胞呈巢状聚集、明显或至少中度的细胞大小不等和核大小不等、多核以及明显的核仁。在超过70%的HC肿瘤中可发现所有这五个标准，假阳性率低于50%。这五个参数中同时出现三个或四个的情况出现在70% - 90%的HC肿瘤中，仅在30%的病例中会导致HC肿瘤的假阳性诊断。采用这些标准可改善甲状腺HC肿瘤的常规细胞学诊断。
