Clear-cell variants of follicular carcinoma are rare subtypes of thyroid cancer. There is no unified view of the histopathological features of clear cell variants, but follicular carcinomas composed predominantly of c...Clear-cell variants of follicular carcinoma are rare subtypes of thyroid cancer. There is no unified view of the histopathological features of clear cell variants, but follicular carcinomas composed predominantly of clear cells are distinguished from clear cell variants. In clinical practice, it is important to determine whether clear cell variants arise primarily from the thyroid gland or are thyroid metastases of other clear cell carcinomas, such as renal cell carcinoma. We present a case in which a patient with initially suspected anaplastic thyroid carcinoma due to a rapidly progressive anterior neck mass was diagnosed with a clear cell variant of follicular carcinoma after a tissue biopsy. The patient was treated with lenvatinib, then his performance status improved, and he was discharged from the hospital. On day 188 after discharge, a contrast-enhanced computed tomography (CECT) scan of the neck showed further shrinkage of the tumor. However, a CECT scan of the chest revealed multiple lung metastases. On day 233 after discharge, the patient developed severe pneumonia resulting from tracheal rupture due to intratumoral necrosis. It was difficult to decide whether lenvatinib should have been discontinued or reduced when lung metastasis appeared. It is necessary to accumulate additional cases to make informed decisions about continuing lenvatinib therapy.展开更多
Follicular thyroid carcinoma(FTC)is the second most common form of thyroid malignancy,and it is associated with more aggressive growth and worse long-term survival outcomes relative to papillary thyroid carcinoma(PTC)...Follicular thyroid carcinoma(FTC)is the second most common form of thyroid malignancy,and it is associated with more aggressive growth and worse long-term survival outcomes relative to papillary thyroid carcinoma(PTC).Reliable approaches to preoperative FTC detection,however,remain to be established.Herein,a targeted Affibody-Au-Tripod nanoprobe was developed and successfully utilized to facilitate the targeted photoacoustic imaging(PAI)of epidermal growth factor receptor(EGFR)-positive cells and tumors.These Affibody-Au-Tripods were found to be highly sensitive and specific for cells expressing EGFR when used as a PA contrast agent in vitro,and studies conducted in an FTC-133 subcutaneous tumor model system in mice further revealed that these Affibody-Au-Tripods were able to specifically target these EGFR-expressing tumors while providing a strong photoacoustic signal in vivo.Importantly,these nanoprobes exhibited negligible cytotoxicity and robust chemical and physical stability,making Affibody-Au-Tripods promising candidates for targeted PAI-based FTC diagnosis.In addition,these nanoprobes have the potential to facilitate the individualized treatment of patients harboring EGFRpositive tumors.展开更多
Aim: Follicular variant of papillary thyroid carcinoma [FVPC] as a diagnostic entity has been beset by many controversies. In this study, we describe the nuclear features essential for the diagnosis and analyze the di...Aim: Follicular variant of papillary thyroid carcinoma [FVPC] as a diagnostic entity has been beset by many controversies. In this study, we describe the nuclear features essential for the diagnosis and analyze the difficulties that confront pathologists as it is important to avoid pitfalls because appropriate management protocol depends upon on an accurate diagnosis of this variant. Materials and Methods: A total of 30 cases, diagnosed as FVPC over a period of two years in the Department of Pathology, were taken for the study. Haematoxylin and Eosin stained sections were reviewed. The extent and distribution of nuclear features were analyzed. Results: The 30 cases of FVPC were categorized into encapsulated and infiltrative groups basing on the presence or lack of capsule and capsular invasion and vascular invasion. Conclusion: FVPC is diagnosed basing on specific nuclear features and hence histopathology still remains the gold standard for the accurate diagnosis.展开更多
BACKGROUND Thyroid follicular renal cell carcinoma is a special type of renal cell carcinoma newly recognized in recent years.It has attracted attention because of its unique histology,immunophenotype,and clinical cha...BACKGROUND Thyroid follicular renal cell carcinoma is a special type of renal cell carcinoma newly recognized in recent years.It has attracted attention because of its unique histology,immunophenotype,and clinical characteristics.It has a very low incidence,and the number of case reports available for review is limited.Moreover,a thyroid mass with type of tumour is rare.CASE SUMMARY We report a case of a renal mass with a bilateral thyroid mass that was accidentally discovered in a 60-year-old man during physical examination.B-mode ultrasound showed a hypoechoic mass in the middle and lower parenchyma of the right kidney,and computed tomography showed an iso-density shadow tumour in the right kidney.Contrast agents had a significant continuous enhancement effect on the tumour,and the enhancement was not uniform.After partial nephrectomy,pathological analysis was performed to rule out the possibility that the renal tumour was caused by thyroid tumour metastasis.Needle biopsy of the thyroid tumour confirmed that the renal cell carcinoma was not related to the thyroid tumour.The patient was alive at the last postoperative follow-up.CONCLUSION This is the third published case in which thyroid tumour biopsy was performed to confirm that thyroid follicular renal cell carcinoma is not thyroid related.展开更多
目的探讨RAS基因在甲状腺滤泡状癌(FTC)中的表达与FTC患者临床特征的相关性。方法收集34例甲状腺滤泡状癌患者年龄、性别、结节纵横比、结节回声、结节钙化、甲状腺影像报告和数据系统的分级(TI-RADS)分类、肿瘤大小、淋巴结转移情况、...目的探讨RAS基因在甲状腺滤泡状癌(FTC)中的表达与FTC患者临床特征的相关性。方法收集34例甲状腺滤泡状癌患者年龄、性别、结节纵横比、结节回声、结节钙化、甲状腺影像报告和数据系统的分级(TI-RADS)分类、肿瘤大小、淋巴结转移情况、体质量指数(BMI)及临床分期资料,检测术前甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、促甲状腺激素(TSH)及甲状腺激素(TH)水平,采用扩增阻滞突变系统多聚酶链式扩增(ARMS-PCR)技术检测RAS(KRAS/HRAS/NRAS)的突变状态,实时荧光定量PCR技术(qPCR)检测KRAS、NRAS、HRAS基因突变情况,采用单因素分析基因突变与临床特征的相关性。结果15例发生RAS基因突变(NRAS、KRAS、HRAS),突变率为44.1%,其中NRAS突变10例(29.4%)、KRAS突变4例(11.8%)、HRAS突变1例(3.0%);<55岁患者有18例、≥55岁有16例,且与RAS基因突变有关(P<0.05),TI-RADS分类4类及以上25例;肿瘤<1 cm患者有11例、1~4 cm 10例,>4 cm 13例,均与RAS基因突变有关(P<0.05)。结论RAS的突变状态与患者年龄及肿瘤大小相关,与其他临床特征无相关性。展开更多
BACKGROUND Inflammatory pseudotumor-like follicular dendritic cell sarcoma(IPT-like FDCS)is rare with a low malignant potential.Hepatic IPT-like FDCS has similar clinical features to hepatocellular carcinoma(HCC),maki...BACKGROUND Inflammatory pseudotumor-like follicular dendritic cell sarcoma(IPT-like FDCS)is rare with a low malignant potential.Hepatic IPT-like FDCS has similar clinical features to hepatocellular carcinoma(HCC),making it extremely difficult to distinguish between them in clinical practice.We describe the case of a young female patient diagnosed with HCC before surgery,which was pathologically diagnosed as IPT-like FDCS after the left half of the liver was resected.During 6 mo of follow-up,the patient recovered well with no signs of recurrence or metastasis.CASE SUMMARY A 23-year-old female patient with a 2-year history of hepatitis B presented to the Affiliated Hospital of Guizhou Medical University.She was asymptomatic at presentation,and the findings from routine laboratory examinations were normal except for slightly elevated alpha-fetoprotein levels.However,ultrasonography revealed a 3-cm diameter mass in the left hepatic lobe,and abdominal contrastenhanced computed tomography revealed that the tumor had asymmetrical enhancement during the arterial phase,which declined during the portal venous phase,and had a pseudo-capsule appearance.Based on the findings from clinical assessments and imaging,the patient was diagnosed with HCC,for which she was hospitalized and had undergone laparoscopic left hepatectomy.However,the tumor specimens submitted for pathological analyses revealed IPT-like FDCS.After surgical removal of the tumor,the patient recovered.In addition,the patient continued to recover well during 6 mo of follow-up.CONCLUSION Hepatic IPT-like FDCS is difficult to distinguish from HCC.Hepatectomy may provide beneficial outcomes in non-metastatic hepatic IPT-like FDCS.展开更多
Background: Classical teaching dictates that follicular adenoma (FA) can be distinguished from follicular carcinoma (FC) based on histologic features only. We retrospectively reviewed our institution’s 10-year experi...Background: Classical teaching dictates that follicular adenoma (FA) can be distinguished from follicular carcinoma (FC) based on histologic features only. We retrospectively reviewed our institution’s 10-year experience in the use of fine-needle aspiration (FNA) to diagnose follicular thyroid neoplasms. Methods: Patients who had FNA of a thyroid neoplasm from 2000 to 2010 were reviewed. Diagnoses of FA, FC, or follicular neoplasm-not otherwise specified (NOS) were included. Cytopathological results were correlated with surgical pathology. Results: Of 138 patients, 65% underwent surgery. FNA diagnosis for FA had a sensitivity of 50% and specificity of 71%. 25% of patients with an FNA diagnosis of FA were found to have cancer after surgical specimen examination. FNA diagnosis for FC had a sensitivity of 60% and specificity of 94%. Conclusions: FNA has a low sensitivity for diagnosing FA. Surgical pathology remains the gold standard for differentiating follicular carcinoma from adenoma.展开更多
文摘Clear-cell variants of follicular carcinoma are rare subtypes of thyroid cancer. There is no unified view of the histopathological features of clear cell variants, but follicular carcinomas composed predominantly of clear cells are distinguished from clear cell variants. In clinical practice, it is important to determine whether clear cell variants arise primarily from the thyroid gland or are thyroid metastases of other clear cell carcinomas, such as renal cell carcinoma. We present a case in which a patient with initially suspected anaplastic thyroid carcinoma due to a rapidly progressive anterior neck mass was diagnosed with a clear cell variant of follicular carcinoma after a tissue biopsy. The patient was treated with lenvatinib, then his performance status improved, and he was discharged from the hospital. On day 188 after discharge, a contrast-enhanced computed tomography (CECT) scan of the neck showed further shrinkage of the tumor. However, a CECT scan of the chest revealed multiple lung metastases. On day 233 after discharge, the patient developed severe pneumonia resulting from tracheal rupture due to intratumoral necrosis. It was difficult to decide whether lenvatinib should have been discontinued or reduced when lung metastasis appeared. It is necessary to accumulate additional cases to make informed decisions about continuing lenvatinib therapy.
基金supported by the National Natural Science Foundation of China(81421004,81301268)Beijing Nova Program Interdisciplinary Cooperation Project (xxjc201812)+2 种基金International S&T Cooperation Program of China(2015DFA30440)Beijing Nova Program(Z131107000413063)CAMS Innovation Fund for Medical Sciences(CIFMS 2020-I2M-C&T-B-035)。
文摘Follicular thyroid carcinoma(FTC)is the second most common form of thyroid malignancy,and it is associated with more aggressive growth and worse long-term survival outcomes relative to papillary thyroid carcinoma(PTC).Reliable approaches to preoperative FTC detection,however,remain to be established.Herein,a targeted Affibody-Au-Tripod nanoprobe was developed and successfully utilized to facilitate the targeted photoacoustic imaging(PAI)of epidermal growth factor receptor(EGFR)-positive cells and tumors.These Affibody-Au-Tripods were found to be highly sensitive and specific for cells expressing EGFR when used as a PA contrast agent in vitro,and studies conducted in an FTC-133 subcutaneous tumor model system in mice further revealed that these Affibody-Au-Tripods were able to specifically target these EGFR-expressing tumors while providing a strong photoacoustic signal in vivo.Importantly,these nanoprobes exhibited negligible cytotoxicity and robust chemical and physical stability,making Affibody-Au-Tripods promising candidates for targeted PAI-based FTC diagnosis.In addition,these nanoprobes have the potential to facilitate the individualized treatment of patients harboring EGFRpositive tumors.
文摘Aim: Follicular variant of papillary thyroid carcinoma [FVPC] as a diagnostic entity has been beset by many controversies. In this study, we describe the nuclear features essential for the diagnosis and analyze the difficulties that confront pathologists as it is important to avoid pitfalls because appropriate management protocol depends upon on an accurate diagnosis of this variant. Materials and Methods: A total of 30 cases, diagnosed as FVPC over a period of two years in the Department of Pathology, were taken for the study. Haematoxylin and Eosin stained sections were reviewed. The extent and distribution of nuclear features were analyzed. Results: The 30 cases of FVPC were categorized into encapsulated and infiltrative groups basing on the presence or lack of capsule and capsular invasion and vascular invasion. Conclusion: FVPC is diagnosed basing on specific nuclear features and hence histopathology still remains the gold standard for the accurate diagnosis.
基金Supported by Natural Science Foundation of Jiangxi Province,No.2010GZY0806。
文摘BACKGROUND Thyroid follicular renal cell carcinoma is a special type of renal cell carcinoma newly recognized in recent years.It has attracted attention because of its unique histology,immunophenotype,and clinical characteristics.It has a very low incidence,and the number of case reports available for review is limited.Moreover,a thyroid mass with type of tumour is rare.CASE SUMMARY We report a case of a renal mass with a bilateral thyroid mass that was accidentally discovered in a 60-year-old man during physical examination.B-mode ultrasound showed a hypoechoic mass in the middle and lower parenchyma of the right kidney,and computed tomography showed an iso-density shadow tumour in the right kidney.Contrast agents had a significant continuous enhancement effect on the tumour,and the enhancement was not uniform.After partial nephrectomy,pathological analysis was performed to rule out the possibility that the renal tumour was caused by thyroid tumour metastasis.Needle biopsy of the thyroid tumour confirmed that the renal cell carcinoma was not related to the thyroid tumour.The patient was alive at the last postoperative follow-up.CONCLUSION This is the third published case in which thyroid tumour biopsy was performed to confirm that thyroid follicular renal cell carcinoma is not thyroid related.
文摘目的探讨RAS基因在甲状腺滤泡状癌(FTC)中的表达与FTC患者临床特征的相关性。方法收集34例甲状腺滤泡状癌患者年龄、性别、结节纵横比、结节回声、结节钙化、甲状腺影像报告和数据系统的分级(TI-RADS)分类、肿瘤大小、淋巴结转移情况、体质量指数(BMI)及临床分期资料,检测术前甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、促甲状腺激素(TSH)及甲状腺激素(TH)水平,采用扩增阻滞突变系统多聚酶链式扩增(ARMS-PCR)技术检测RAS(KRAS/HRAS/NRAS)的突变状态,实时荧光定量PCR技术(qPCR)检测KRAS、NRAS、HRAS基因突变情况,采用单因素分析基因突变与临床特征的相关性。结果15例发生RAS基因突变(NRAS、KRAS、HRAS),突变率为44.1%,其中NRAS突变10例(29.4%)、KRAS突变4例(11.8%)、HRAS突变1例(3.0%);<55岁患者有18例、≥55岁有16例,且与RAS基因突变有关(P<0.05),TI-RADS分类4类及以上25例;肿瘤<1 cm患者有11例、1~4 cm 10例,>4 cm 13例,均与RAS基因突变有关(P<0.05)。结论RAS的突变状态与患者年龄及肿瘤大小相关,与其他临床特征无相关性。
基金Supported by Guizhou Medical UniversityAffiliated Hospital of Guizhou Medical University
文摘BACKGROUND Inflammatory pseudotumor-like follicular dendritic cell sarcoma(IPT-like FDCS)is rare with a low malignant potential.Hepatic IPT-like FDCS has similar clinical features to hepatocellular carcinoma(HCC),making it extremely difficult to distinguish between them in clinical practice.We describe the case of a young female patient diagnosed with HCC before surgery,which was pathologically diagnosed as IPT-like FDCS after the left half of the liver was resected.During 6 mo of follow-up,the patient recovered well with no signs of recurrence or metastasis.CASE SUMMARY A 23-year-old female patient with a 2-year history of hepatitis B presented to the Affiliated Hospital of Guizhou Medical University.She was asymptomatic at presentation,and the findings from routine laboratory examinations were normal except for slightly elevated alpha-fetoprotein levels.However,ultrasonography revealed a 3-cm diameter mass in the left hepatic lobe,and abdominal contrastenhanced computed tomography revealed that the tumor had asymmetrical enhancement during the arterial phase,which declined during the portal venous phase,and had a pseudo-capsule appearance.Based on the findings from clinical assessments and imaging,the patient was diagnosed with HCC,for which she was hospitalized and had undergone laparoscopic left hepatectomy.However,the tumor specimens submitted for pathological analyses revealed IPT-like FDCS.After surgical removal of the tumor,the patient recovered.In addition,the patient continued to recover well during 6 mo of follow-up.CONCLUSION Hepatic IPT-like FDCS is difficult to distinguish from HCC.Hepatectomy may provide beneficial outcomes in non-metastatic hepatic IPT-like FDCS.
文摘Background: Classical teaching dictates that follicular adenoma (FA) can be distinguished from follicular carcinoma (FC) based on histologic features only. We retrospectively reviewed our institution’s 10-year experience in the use of fine-needle aspiration (FNA) to diagnose follicular thyroid neoplasms. Methods: Patients who had FNA of a thyroid neoplasm from 2000 to 2010 were reviewed. Diagnoses of FA, FC, or follicular neoplasm-not otherwise specified (NOS) were included. Cytopathological results were correlated with surgical pathology. Results: Of 138 patients, 65% underwent surgery. FNA diagnosis for FA had a sensitivity of 50% and specificity of 71%. 25% of patients with an FNA diagnosis of FA were found to have cancer after surgical specimen examination. FNA diagnosis for FC had a sensitivity of 60% and specificity of 94%. Conclusions: FNA has a low sensitivity for diagnosing FA. Surgical pathology remains the gold standard for differentiating follicular carcinoma from adenoma.
