柱状细胞亚型甲状腺乳头状癌的细针穿刺细胞学特点分析

Cytological characteristics of columnar cell variant of papillary thyroid carcinoma with fine-needle aspiration

目的探讨柱状细胞亚型甲状腺乳头状癌(papillary thyroid carcinoma-columnar cell variant,CCV-PTC)的细针穿刺细胞学(fine needle aspiration cytology,FNAC)特征。方法回顾性分析3例诊断为CCV-PTC患者的临床资料、FNAC特征、免疫表型及BRAF V600E基因检测结果,并复习相关文献。结果3例患者中男性1例,女性2例,年龄27、30、49岁;结节大小0.5、1、1.2 cm。FNAC特征:细胞排列以蜂窝状细胞团为主;细胞片边缘细胞拉长、细胞核排列成假复层;细胞核深染、排列重叠拥挤;罕见核沟、核内假包涵体及核仁。免疫表型:3例均表达CDX-2及TTF1,2例局部表达TG。BRAF V600E基因检测:2例突变,1例野生型。2例术后组织病理诊断为CCV-PTC,1例细胞蜡块切片诊断为CCV-PTC。结论CCV-PTC的细针穿刺细胞学特点不同于经典型PTC,认识CCV-PTC的FNAC特点有助于细胞学诊断CCV-PTC。

Objective To study the fine needle aspiration cytology(FNAC)features of papillary thyroid carcinoma-columnar cell variant(CCV-PTC).Methods The clinical features,cytological features of the aspirated specimens,immunophenotype and BRAF V600 E gene test of 3 CCV-PTC cases were evaluated retrospectively and related literatures were reviewed.Results Three cases were 1 male and 2 females;the age ranged from 27 to 49 years;the thyroid nodules maximum diameter was 0.7 cm-1.2 cm.All cases demonstrated the presence of a honeycomb pattern;the cellular silhouette of the edge of the cell clusters was elongated and the nuclei of the edge cells presented pseudostratification;hypercellularity with nuclear superposition and a paucity of nuclear pseudoinclusions and grooves were the most important features observed in PTC-CCV FNA.Immunohistoehemically,3 cases expressd CDX-2 and TTF-1;1 cases showed positive expression of TG.The BRAF oncogene(BRAF V600E)was detected in two of three cases.Conclusion Cytomorphological characteristics of CCV-PTC is different from the classic variant of PTC,and understanding the FNAC features of CCV-PTC is helpful for diagnosis of CCV-PTC.