甲状腺髓样癌冰冻误诊原因及病理分析

Causes of Frozen Section Misdiagnosis and Clinicopathologic Analysis of Medullary Thyroid Carcinoma

目的:探讨甲状腺髓样癌(MTC)的冰冻误诊原因,提高其诊断的准确性。方法:对两例MTC的冰冻误诊原因进行临床与组织病理学分析。结果:两例MTC患者均为男性,年龄分别为50岁及52岁,肿物最大径分别为2.3 cm及2.8 cm。由于术中冰冻切片中细胞异型不明显,肿瘤界限清楚,未能做出正确诊断。常规病理及免疫组化均证实为MTC。结论:MTC术中冰冻易误诊,但采用免疫组化能够确诊。通过加强对MTC的认识,术前检测降钙素与癌胚抗原水平能提高冰冻诊断的准确性。

Objective:To explore the causes of frozen section misdiagnosis of medullary thyroid carcinoma(MTC)and improve the accuracy of its diagnosis.Method:Clinical and histopathological analysis was made on the causes of frozen section misdiagnosis in two cases of MTC.Result:Two cases of MTC were male,aged 50 and 52 years,and the maximum diameter of the tumor were 2.3 and 2.8 cm.Because the cell atypia was not obvious in the frozen section,and the tumor boundaries were clear,so the correct diagnosis could not be made.Conventional pathology and immunohistochemistry confirmed MTC.Conclusion:MTC is easy to misdiagnose in frozen section during operation,but it can be diagnosed by immunohistochemistry.By strengthening the understanding of MTC,and the levels of calcitonin and carcinoembryonic antigen can be detected before operation,and the accuracy of frozen section diagnosis can be improved.