Karak A K, Sahoo M, Bhatnagar D
Department of Pathology, All India Institute of Medical Sciences, INMAS, New Delhi.
Indian J Pathol Microbiol. 1998 Oct;41(4):479-84.
Hyalinizing trabecular adenoma is a recently described benign thyroid tumor, almost exclusively occurring in females. The morphological features of this entity overlap with both papillary and medullary carcinoma to varying extent. This, in turn, creates a situation of serious diagnostic pitfall particularly for a false positive diagnosis of papillary carcinoma in fine needle aspiration (FNA) cytology. False consideration of medullary carcinoma is also possible by the unwary especially if staining for Congo red and/or immunostaining for calcitonin is not resorted to. At histologic level, the distinctive architectural pattern is however of great help and thus poses a much lesser danger of misdiagnosis. We relate here our experience in a recently encountered case of hyalinizing trabecular adenoma and describe detailed FNA cytologic and histologic findings along with immunohistochemical profile using a panel of eight monoclonal antibodies. The tumor proliferative potential has also been assessed using MIB-1 (Ki-67) immunostaining. The various pros and cons of diagnostic pitfalls are discussed.
透明变梁状腺瘤是一种最近才被描述的良性甲状腺肿瘤，几乎仅见于女性。该实体的形态特征在不同程度上与乳头状癌和髓样癌都有重叠。这反过来又造成了严重的诊断陷阱，尤其是在细针穿刺（FNA）细胞学检查中对乳头状癌的假阳性诊断。粗心的人也可能错误地认为是髓样癌，特别是如果未采用刚果红染色和/或降钙素免疫染色的话。然而，在组织学水平上，独特的结构模式很有帮助，因此误诊的风险要小得多。我们在此讲述我们最近遇到的一例透明变梁状腺瘤的经验，并描述详细的FNA细胞学和组织学发现以及使用一组八种单克隆抗体的免疫组化特征。还使用MIB-1（Ki-67）免疫染色评估了肿瘤的增殖潜能。讨论了诊断陷阱的各种利弊。
