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首页> 外文期刊>Acta Cytologica: The Journal of Clinical Cytology and Cytopathology >Fine needle aspiration cytology of mixed medullary-follicular thyroid carcinoma: a case report.
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Fine needle aspiration cytology of mixed medullary-follicular thyroid carcinoma: a case report.

机译：混合型甲状腺髓样甲状腺癌细针穿刺细胞学检查：一例报告。

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摘要

BACKGROUND: Mixed medullary-follicular thyroid carcinoma (MMFTC) is a rare tumor that has been regarded as a clinicopathologic variant of medullary thyroid carcinoma. MMFTC represents a diagnostic challenge by fine needle aspiration cytology (FNAC). CASE: A 77-year-old woman had a palpable mass on the left side of the neck. It was diagnosed as follicular neoplasm by FNAC; she underwent total thyroidectomy. Pathology revealed follicular carcinoma. Radioactive iodine was administered. An enlarging mass was present in the left mandible later. FNAC showed suspicious follicular neoplasm with predominance of oncocytic cells. Pathology revealed follicular carcinoma with parafollicular cell differentiation. Immunohistochemical analysis demonstrated positive status for thyroglobulin and calcitonin. Simultaneous expression of thyroglobulin and calcitonin within the same neoplastic cell was considered. She underwent several courses of radioactive iodine therapy without significant effect. Interestingly, her serumcalcitonin level was not elevated. CONCLUSION: Coexpression of thyroglobulin and calcitonin in the same cell is very rare. The component of medullary carcinoma should be considered when encountering an atypical thyroid carcinoma with predominance of cells showing oncocytic changes on FNAC and with clinically poor response to conventional treatment. Immunohistochemistry and pathologic analyses are helpful to confirm the diagnosis, especially in the absence of elevated serum calcitonin level.
机译：背景：混合甲状腺髓样癌（MMFTC）是一种罕见的肿瘤，被认为是甲状腺髓样癌的临床病理变异。 MMFTC通过细针穿刺细胞学（FNAC）代表了诊断挑战。案例：一位77岁的女性在颈部左侧有明显的肿块。 FNAC诊断为滤泡性肿瘤;她接受了全甲状腺切除术。病理显示滤泡状癌。施用放射性碘。稍后在左下颌骨中出现肿块。 FNAC显示可疑的滤泡性肿瘤，以吞噬细胞为主。病理显示滤泡癌伴滤泡旁细胞分化。免疫组织化学分析显示甲状腺球蛋白和降钙素呈阳性状态。考虑在同一肿瘤细胞中甲状腺球蛋白和降钙素同时表达。她接受了几个疗程的放射性碘治疗，但未见明显效果。有趣的是，她的血清降钙素水平并未升高。结论：甲状腺球蛋白和降钙素在同一细胞中的共表达非常罕见。当遇到非典型甲状腺癌时，应考虑髓样癌的成分，其中非典型甲状腺癌的细胞主要表现出FNAC上的胞浆变化，并且对常规治疗的临床反应较差。免疫组织化学和病理学分析有助于确定诊断，尤其是在血清降钙素水平不升高的情况下。

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