Granter S R, Cibas E S
Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA.
Am J Clin Pathol. 1997 Jan;107(1):20-5. doi: 10.1093/ajcp/107.1.20.
Findings in seven cytologic specimens obtained with fine-needle aspiration biopsy were described in three patients in whom thyroid nodules developed after iodine 131 treatment of hyperthyroidism. In two patients, the presence of large bizarre cells with hyperchromatic nuclei, coarse chromatin, and prominent nucleoli suggested the possibility of malignancy, and in particular, anaplastic carcinoma. These bizarre nuclear changes were diffuse in one patient and focal in the other. In the third patient, nuclei with chromatin clearing, grooves, and nuclear pseudoinclusions suggested papillary carcinoma. At follow-up, lesions were benign in all three patients. We conclude that nuclear changes suggestive of either anaplastic carcinoma or papillary carcinoma may be seen in thyroid nodules after 131I treatment. Clues to the benign nature of these nodules include architectural arrangement of cells in cohesive clusters and flat sheets; presence of lymphocytes, histiocytes, colloid, cytoplasmic vacuoles, and Hürthle cells; and a clinical history of treatment with radioactive iodine.
对3例甲状腺功能亢进症患者经碘131治疗后出现甲状腺结节的患者，其7份细针穿刺活检获得的细胞学标本的检查结果进行了描述。在2例患者中，存在核大、形态怪异、核染色质深染、粗糙且核仁突出的细胞，提示有恶性肿瘤的可能，尤其是未分化癌。这些怪异的核改变在1例患者中呈弥漫性，在另1例中呈局灶性。在第3例患者中，核染色质透亮、有沟及核假包涵体提示为乳头状癌。随访时，所有3例患者的病变均为良性。我们得出结论，在碘131治疗后的甲状腺结节中可能会出现提示未分化癌或乳头状癌的核改变。这些结节为良性的线索包括细胞呈凝聚性团块和平片状的结构排列；存在淋巴细胞、组织细胞、胶质、胞质空泡和许特莱细胞；以及有放射性碘治疗的临床病史。
