包膜内型甲状腺乳头状癌与经典甲状腺乳头状癌超声和病理对照分析

Sonographic and pathologic features of encapsulated papillary thyroid carcinomas in comparison with classical papillary thyroid carcinomas

目的:探讨包膜内型甲状腺乳头状癌(EPTC)与经典甲状腺乳头状癌(CPTC)的超声及病理特征的差异。方法:对经手术病理确诊的33例EPTC和85例CPTC的超声表现及其病理特征进行对照分析。33例EPTC按照病理组织学成分的不同分为包膜经典乳头型(E-CPTC)21例和包膜滤泡型(E-FVPTC)12例。结果:21例E-CPTC患者的超声表现,肿块边缘成角18例,回声明显减低17例,伴微钙化13例;E-FVPTC组12例中,肿块边缘光整11例,中等回声9例,周边多见晕圈9例,缺乏微钙化12例;CPTC组85例中,肿块形态不规则9例,回声明显减低66例,伴微钙化51例。E-CPTC和E-FVPTC均可见完整的纤维包膜,CPTC未见明显包膜。E-CPTC、E-FVPTC和CPTC癌细胞内均可见乳头状癌特有的细胞核。结论:EPTC组和CPTC组肿块超声表现相似,E-FVPTC组肿块超声显示相对良性的特征。病理组织学表现,E-CPTC和CPTC具有乳头状结构,E-FVPTC癌细胞完全或几乎完全呈滤泡结构。

OBJECTIVE： To investigate the sonographic and pathological features of encapsulated papillary thyroid carcinoma （EPTC） and classical papillary thyroid carcinoma （CPTC）. METHODS： Thirty-three EPTC and 85 CPTC contimed by pathology were enrolled in this study. Thirty-three EPTC were divided into two groups： 21 E-CPTC（encapsulated classical papillary thyroid carcinomas） and 12 E-FVPTC（encapsulated follicular variant papillary thyroid carcinomas）. The sonographic features, pathological features were compared among the three groups. RESULTS： The ultrasound features of 21 E-CPTC were： 18 spiculated margin, 17 markedly hypoechoic, 13 microcalcification 12 E-FVPTC were： 11 smooth margin, 9 isoechoic, 9 more hypoechoic halo, 12 lack of microcalcification; 85 CPTC were： 9 irregular shape, 66 markedly hypoechoic, 51 microcalcification Pathological findings：Both E-CPTC and E-FVPTC had a complete fibrous capsule. CPTC had no capsules. In all three groups there were specific to papillary carcinoma nucleus. CONCLUSIONS： The sonographic features of the E-CPTC and the CPTC are similar the ultrasound features of the E-FVPTC are similar to benign thyroid nodules. Histopathology features were that E-CPTC and CPTC have papillary structure and E-FVPTC has complete or almost complete follicular structure.