Cytologic clues for distinguishing the tall cell variant of thyroid papillary carcinoma. A case report.
Cytologic clues for distinguishing the tall cell variant of thyroid papillary carcinoma. A case report.
复制标题
区分甲状腺乳头状癌高细胞变体的细胞学线索。
DOI：
10.1159/000333526
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发表时间：
1997
期刊：
影响因子：
1.8
通讯作者：
F. Barreiro
中科院分区：
文献类型：
--
作者：
J. Cameselle;C. Febles;J. Cameselle;N. Alfonsin;J. Moldes;F. Barreiro
背景
与典型乳头状癌相比，高细胞变异型甲状腺乳头状癌具有更强的侵袭性。基于细针吸取细胞学(FNAC)对乳头状癌的TCV作出特异性诊断的尝试并不令人满意。
大案
本文对1例乳头状癌的细胞学和组织学进行了研究，重点分析了FNAC涂片诊断乳头状癌TCV的主要组织学标准。“高细胞”被定义为具有丰富的嗜酸性、拉长的细胞质；这些细胞的高度是其宽度的两倍或更多，并且它们必须构成肿瘤细胞群的30%。20例非侵袭性乳头状癌作为对照，涂片中未见Tall细胞。在乳头状癌TCV的两张载玻片中，只有1例(5%)有一张有丝分裂像，而乳头状癌的两张有丝分裂像有两张和三张。
结论
除了典型乳头状癌的常规细胞学特征外，同一涂片中高细胞和有丝分裂像的识别高度提示乳头状癌的TCV。还需要更多的研究来证实这一线索的有效性。
BACKGROUND
In contrast to typical papillary carcinoma, the tall cell variant (TCV) of thyroid papillary carcinoma has more aggressive biologic behavior. Attempts to make a specific diagnosis of TCV of papillary carcinoma based on fine needle aspiration cytology (FNAC) have been unsatisfactory.
CASE
The cytologic and histologic study of one such case was made with an emphasis given to identifying the main histologic criteria for the specific diagnosis of TCV of papillary carcinoma in FNAC smears. "Tall cells" were defined as cells with abundant eosinophilic, elongated cytoplasm; the height of these cells was twice their width or more, and they have to constitute > 30% of the tumor cell population. Tall cells were not found in smears of 20 cases of nonaggressive papillary carcinomas investigated as control cases. Only one mitotic figure was found in one slide of one of the control cases (5%) in comparison to two and three mitotic figures found in the two slides of TCV of papillary carcinoma.
CONCLUSION
In addition to conventional cytologic features of typical papillary carcinoma, the identification of both tall cells and mitotic figures in the same smears is highly indicative of TCV of papillary carcinoma. More studies will be necessary to confirm the usefulness of this clue.