.یک خانم 22 ساله از کتله در قدام عنق یا غده درقیه شاکیست

معاینه با سوزن باریک فولیکولر نیوپلازم را نشان میدهد که میتواند ادینوم یا هم کارسینوم باشد و فرق بین این دو در بیوپسی آشکار میشود. در بیوپسی چون تهاجم کپسول تومور و اوعیه های تومور توسط تومور دیده نشد پس این یک ادینوم بوده نه کارسینوم (جهت معلومات بیشتر متن انگلیسی و تصاویر ذیل را مرور نمایید)

  • Follicular Adenoma: Benign tumor that shows evidence of follicular differentiation but lacks evidence of capsular and vascular invasion and lacks papillary carcinoma nuclear features.
  • Epidemiology: Adults, usually 20 – 50 years , M:F = 1:6

Clinical features / diagnosis:

  • Presents with long standing solitary thyroid nodule
  • Almost always solitary; if multiple, diagnose as multinodular goiter with adenomatous change.

Laboratory: Patient is usually euthyroid

Radiology description: Usually “cold” nodule, may be “warm” but rarely “hot”

Treatment: Lobectomy (not enucleation)

Gross description:

  • Solitary, encapsulated, variable size (1 – 10 cm), In our case tumor size was 1.5 cm.
  • Solid, fleshy, tan to light brown
  • Bulges when fresh, compresses adjacent thyroid
  • Resembles multinodular goiter due to secondary changes of hemorrhage and cystic degeneration

Microscopic (histologic) description:

  • Completely enveloped by thin fibrous capsule.
  • Architecturally and cytologically different from surrounding gland; surrounding thyroid tissue shows signs of compression
  • Closely packed follicles, trabeculae or solid sheets
  • Cuboidal to low columnar cells, pale staining with round inconspicuous nucleoli
  • Mitoses are uncommon
  • Commonly secondary changes of hemorrhage, hemosiderin deposition, sclerosis, edema, necrosis and cystic changes
  • No capsular or vascular invasion after thorough sampling (at least 10 blocks), no / rare mitotic figures, no papillary nuclear features

Cytology description:

  • High cellularity, syncytial 3 dimensional arrangement, prominent nuclear crowding with some follicular arrangemen, but no papillary nuclear features, minimal colloid.
  • Cannot rule out carcinoma based on cytologic findings.
POSTED BY nasirpath | Mar, 29, 2022 |