Towards an international pediatric liver tumor consensus classification : proceedings of the Los Angeles COG liver tumors symposium
Towards an international pediatric liver tumor consensus classification : proceedings of the Los Angeles COG liver tumors symposium
复制标题
迈向国际儿科肝脏肿瘤共识分类：洛杉矶 COG 肝脏肿瘤研讨会记录
DOI：
10.1038/modpathol.2013.8
复制
发表时间：
2013
期刊：
影响因子：
7.5
通讯作者：
et al
中科院分区：
文献类型：
--
作者：
Lopez-Terrada D;Hiyama E;et al
背景近年来的研究表明，具有鞋钉样特征的甲状腺乳头状癌（PTC）是一种罕见的，但侵袭性很强的PTC。HPTC的细针穿刺涂片细胞学特征未见报道。设计我们对5例HPTC的涂片和细胞块进行了检查，以确定其诊断性细胞学特征。通过焦磷酸测序研究所有病例中的B-RAF突变。进一步从手术标本中获得组织学和免疫组化数据。随访资料来自病历review.ResultsThe患者（3女2男）年龄范围从27至86（平均65）岁。肿瘤大小为2 ~ 9 cm（平均4.2 cm）。所有抽吸物都是高度细胞化的，背景带血，胶体很少。细胞呈乳头状簇或微乳头状群排列。孤立的细胞与集群的比例因情况而异。细胞群由小至中等大小的细胞组成，具有泪滴状细胞质，顶部偶尔有凹槽的细胞核，产生表面凸起，导致鞋钉外观和高N/C比。在高倍镜下，细胞核显示不同程度的肿胀，偶见粉红色的核内孔。核分层和不典型的有丝分裂像。3/5例存在B-RAF突变。所有病例组织学切片均显示甲状腺球蛋白、甲状腺转录因子1（TTF-1）阳性，E-cadherin部分缺失，p53蛋白过度表达。4例患者无病存活，1例患者在8.5个月（范围：2至24个月）随访时出现局部复发。ConclusionsA相结合的乳头状/微乳头状和鞋钉状细胞结构的增长模式，单泪滴细胞，高N/C比，严重拥挤可能是最有用的标准诊断HPTC细胞学涂片。
BackgroundRecent reports indicate that papillary thyroid carcinoma (PTC) with hobnail features (HPTC) is a rare, but very aggressive variant of PTC. The cytological features of HPTCs on fine needle aspiration smears have never been described.DesignWe examined smears and cell blocks of 5 cases of HPTC to define their diagnostic cytological features. B-RAF mutation was studied in all cases by pyrosequencing. Histopathological and immunohistochemical data were further obtained from surgical specimens. Follow up information were obtained from medical record review.ResultsThe patients (3 females and 2 males) age ranged from 27 to 86 (mean 65) years. Tumor size ranged from 2 to 9 cm (mean 4, 2 cm). All aspirates were highly cellular with a bloody background and scant colloid. The cells were arranged in papillary clusters or in micropapillary groups. The proportion of isolated cells versus clusters varied from case to case. The cell population consisted of small to medium-size cells with tear-drop cytoplasm, apically placed occasionally grooved nuclei that produced a surface bulge leading to a hobnail appearance and high N/C ratio. At higher magnification, the nuclei showed variable degrees of atypia with occasional pink intranuclear holes. Nuclear stratification and atypical mitotic figures were present. B-RAF mutation was present in 3/5 cases. All cases showed positivity for Thyroglobulin, Thyroid transcription factor-1 (TTF-1), partial loss of E-cadherin expression and over-expressioin of p53 protein on histological sections. Four patients were alive without diseases and 1 patient showed a locoregional recurrence at 8.5 months (range: 2 to 24 months) of follow-up.ConclusionsA combination of papillary/micropapillary and hobnail cyto-architectural patterns of growth, single tear-drop cells, high N/C ratio, severe crowding could be the most useful criteria for diagnosing HPTC on cytological smear.