Anaplastic Thyroid Carcinoma, a Cytologic Perspective: Case Report and Review of Anaplastic Thyroid Carcinoma

L. Goicochea, Paul N. Staats
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引用次数: 1

Abstract

Abstract Anaplastic, or undifferentiated, thyroid carcinoma (ATC) is a highly aggressive disease with less than 1-year survival in nearly all patients with this disease. Because of its aggressive nature, ATC is frequently unresectable. Rapid and accurate pretreatment diagnosis is required to attempt local-regional control. Fine-needle aspiration (FNA) and core-needle biopsy (CNB) are the most widely used initial means of obtaining a tissue diagnosis of this entity, and these specimens are often the only tissue procured before definitive therapy. Although the literature on cytologic diagnosis of ATC is limited, the performance characteristics of FNA appear to be good, with high sensitivity and specificity. However, diagnosis can be challenging because of the variable appearance of aspirated cells of ATC and a broad differential diagnosis that includes medullary carcinoma, poorly differentiated thyroid carcinoma, lymphoma, primary thyroid sarcoma, and metastatic tumors. The use of a limited panel of immunohistochemical stains is often helpful in distinguishing these entities. Although ATC arises in many cases from a well-differentiated thyroid carcinoma, the limited nature of an FNA or CNB specimen usually precludes identification of an associated lower-grade lesion. Herein, we report a case of ATC diagnosed on FNA and CNB and review the diagnosis of ATC from a cytopathology perspective.
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甲状腺间变性癌的细胞学观点:甲状腺间变性癌病例报告及综述
间变性或未分化甲状腺癌(ATC)是一种高度侵袭性疾病,几乎所有患者的生存期都不到1年。由于其侵袭性,ATC通常无法切除。为了尝试局部区域控制,需要快速准确的预处理诊断。细针穿刺(FNA)和芯针活检(CNB)是获得该实体组织诊断的最广泛使用的初始手段,这些标本通常是在确定治疗之前获得的唯一组织。虽然关于ATC细胞学诊断的文献有限,但FNA的表现特点较好,具有较高的敏感性和特异性。然而,由于ATC的吸出细胞的不同外观和广泛的鉴别诊断,包括髓样癌、低分化甲状腺癌、淋巴瘤、原发性甲状腺肉瘤和转移性肿瘤,诊断可能具有挑战性。使用有限的免疫组织化学染色通常有助于区分这些实体。虽然ATC在许多病例中起源于分化良好的甲状腺癌,但FNA或CNB标本的有限性通常排除了相关低级别病变的识别。在此,我们报告一例经FNA和CNB诊断的ATC,并从细胞病理学角度回顾ATC的诊断。
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期刊介绍: Each issue of Pathology Case Reviews examines one vital theme in the field with peer-reviewed, clinically oriented case reports that focus on diagnosis, specimen handling and reports generation. Each theme-oriented issue covers both histopathologic and cytopathologic cases, offering a comprehensive perspective that includes editorials and review articles of the newest developments in the field, differential diagnosis hints, applications of new technologies, reviews of current issues and techniques and an emphasis on new approaches.
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