单纯乳头状甲状腺癌与合并桥本甲状腺炎的乳头状甲状腺癌的临床特点及分析

目的 分析单纯乳头状甲状腺癌(PTC)与PTC合并桥本甲状腺炎(HT)患者的临床特点.方法 将149例PTC患者,按是否合并HT分为PTC组(n=120)与HT-PTC组(n=29).对比两组患者的性别、年龄、术前促甲状腺激素(TSH)水平、甲状腺微小乳头状癌(PTMC)发生率、术后左旋甲状腺激素剂量以及术后TSH抑制...     

Brain metastasis of a papillary renal cell carcinoma, identified as type 2

Papillary renal cell carcinomas (PRCCs) tend to metastasize to lymph nodes, while metastasis to the brain is extremely rare. We report the case of a man who had a brain metastasis of PRCC type 2. He was brought to our hospital due to the sudden onset of convulsions. Diagnostic imaging studies showed a metastatic brain tumor in the left parietal lobe, and a primary renal tumor in the right kidney, with paraaortal lymph node metastases. An excision of brain tumor was performed. The brain tumor had a papillary structure with eosinophilic cytoplasm. Five weeks later nephrectomy was carried out. Histological analysis of the nephrectomy specimen revealed the same papillary structure, which was compatible with PRCC type 2.     

甲状腺乳头状癌与乳头状增生的病理研究

  目的 探讨Galectin3，CK19及Ki-67在甲状腺乳头状癌与乳头状增生中的表达，寻找有助于两者鉴别诊断的标志物。方法 运用免疫组化方法检测100例甲状腺乳头状癌、100例良性乳头状增生中Galectin3，CK19及Ki-67的表达。结果 Galectin3，CK19及Ki-67在甲状腺乳头状癌阳性表达率分别为100 %，97 %及93 %，而在乳头状增生中表达率分别为13 %，30 %及1 %，3种蛋白在乳头状癌与良性乳头状增生间差异有统计学意义（P＜0.05）。在乳头状癌中2种或3种蛋白同时阳性表达为94.3 %，而乳头状增生为0。结论 Galectin3，CK19及Ki-67是鉴别诊断甲状腺乳头状癌与乳头状增生的有用标志物，尤其联合使用更有价值。     

淋巴细胞性甲状腺炎合并甲状腺乳头状癌临床病理分析

目的：探讨淋巴细胞性甲状腺炎合并甲状腺乳头状癌的临床病理特征。方法：对我院及上海市第六人民医院2008-2010年手术切除的166例淋巴细胞性甲状腺炎、淋巴细胞性甲状腺炎合并甲状腺乳头状癌的病理资料进行回顾性分析。结果：淋巴细胞性甲状腺炎、淋巴细胞性甲状腺炎合并甲状腺乳头状癌的平均发病年龄分别为45.5岁、42.5岁,均女性多于男性。淋巴细胞性甲状腺炎合并甲状腺乳头状癌占淋巴细胞性甲状腺炎的25.9%,44例淋巴细胞性甲状腺炎合并甲状腺乳头状癌中35例为甲状腺乳头状微小癌,占淋巴细胞性甲状腺炎合并甲状腺乳头状癌的79.5%。淋巴细胞性甲状腺炎合并甲状腺乳头状癌中7例发生周围淋巴结转移（15.9%）。结论：淋巴细胞性甲状腺炎与甲状腺乳头状癌关系密切,淋巴细胞性甲状腺炎是具有恶性潜能的癌前期病变,淋巴细胞性甲状腺炎合并甲状腺癌以甲状腺乳头状癌多见,微小癌的比例高。     

淋巴细胞性甲状腺炎合并甲状腺乳头状癌临床病理分析

目的 探讨淋巴细胞性甲状腺炎合并甲状腺乳头状癌的临床病理特征.方法 对我院及上海市第六人民医院2008-2010年手术切除的166例淋巴细胞性甲状腺炎、淋巴细胞性甲状腺炎合并甲状腺乳头状癌的病理资料进行回顾性分析.结果 淋巴细胞性甲状腺炎、淋巴细胞性甲状腺炎合并甲状腺乳头状癌的平均发病年龄分别为45.5岁、42.5岁,均女性多于男性.淋巴细胞性甲状腺炎合并甲状腺乳头状癌占淋巴细胞性甲状腺炎的25.9%,44例淋巴细胞性甲状腺炎合并甲状腺乳头状癌中35例为甲状腺乳头状微小癌,占淋巴细胞性甲状腺炎合并甲状腺乳头状癌的79.5%.淋巴细胞性甲状腺炎合并甲状腺乳头状癌中7例发生周围淋巴结转移(15.9%).结论 淋巴细胞性甲状腺炎与甲状腺乳头状癌关系密切,淋巴细胞性甲状腺炎是具有恶性潜能的癌前期病变,淋巴细胞性甲状腺炎合并甲状腺癌以甲状腺乳头状癌多见,微小癌的比例高.     

Skull metastasis revealing a papillary thyroid carcinoma

Although thyroid carcinoma is a relatively common form of malignancy,metastatic spread to the skull is rare.Here,we report a case of papillary thyroid carcinoma with frontal and parietal metastasis.A 61-year-old Chinese woman presented with a one year history of a growing mass on the center of the frontal and parietal bone,initially thought to be meningioma.Biopsy of the skull base mass after intracalvarium excision,indicated a tumor of thyroid origin.One month later the patient underwent a total thyroidectomy.Pathological examination confirmed a diagnosis of papillary thyroid carcinoma with frontal and parietal bone metastasis.Based on this experience,the key to successful management of the skull metastasis of thyroid carcinoma is prompt diagnosis and appropriate treatment.Skull metastasis should be considered at the outset of the clinical course of papillary thyroid cancer.To facilitate this,patients should be meticulously investigated by a multidisciplinary team to improve quality of life.     

甲状腺乳头状癌的变异型

甲状腺乳头状癌(PTC)组织学变异型众多,大部分变异型与典型乳头状癌有相似的临床行为,但有少数变异型预后较差,如高细胞变异型、柱状细胞变异型、实体/梁状变异型等;且有一些变异型在诊断上有争议,如滤泡变异型易误诊为滤泡腺瘤、透明细胞变异型可能与肾细胞癌混淆、诊断高细胞变异型所需的高细胞的比例和细胞高度有分歧意见等.     

Maxillary mass as the presenting manifestation of papillary thyroid carcinoma

A case of follicular variant of papillary thyroid carcinoma presenting with a right maxillary mass is described. This is perhaps the first instance of maxillary metastasis from papillary thyroid carcinoma.     

Pericardial tamponade as initial presentation of papillary thyroid carcinoma.

We herein describe a 19-year-old woman who presented with pericardial effusion that resulted in heart tamponade. The clinicopathological study revealed papillary carcinoma of the thyroid metastasized to the heart. Although malignant pericardial effusion is a known complication of thyroid cancer, it is rarely the first manifestation and shows a relatively favourable prognosis despite widespread metastases if adequate treatment is given.     

The encapsulated papillary carcinoma of the thyroid. A morphologic subtype of the papillary thyroid carcinoma

Of a total of 182 papillary neoplasms, 25 lesions (average size, 3.1 cm) were classified on cytologic and histologic grounds as being encapsulated carcinomas. In eight of these tumors (32.2%) cervical lymph node metastasis and/or intraglandular lymphatic spread was observed. It was not possible to separate on histologic grounds those that did metastasize from those that did not. The excellent prognosis for the encapsulated variant of papillary thyroid carcinoma was confirmed by a long follow-up period in which no evidence of recurrences or further metastasis was registered as compared with the time of initial diagnosis, whatever the mode of therapy. On the basis of these findings, the encapsulated papillary carcinoma can be regarded as an early or slowly growing form of the papillary thyroid carcinoma.     

甲状腺乳头状癌声像图特征探讨

目的:评价甲状腺乳头状癌(papillary thyroid carcinoma,PTC)的声像图特点。方法:回顾性分析34例经手术和病理证实的PTC彩色多普勒超声图像特点。结果:32例(94.1%)低回声,30例(88.2%)结节纵/横≥1,26例(76.5%)伴细微钙化,23例(67.6%)毛剌边缘,29例(85.3%)结节单发,20例(58.8%)边界不清晰,14例(41.2%)侧后方声影,6例(17.6%)检出血流信号,8例(23.5%)颈淋巴结肿大。出现上述异常声像图特征2项以上者占73.5%(25/34)。结论:低回声、微钙化、纵/横≥1、边界、毛剌是PTC具有特征性的超声表现。     

Inherited aspects of papillary thyroid carcinoma

The presence of papillary carcinoma of the thyroid in multiple generations of one kindred is a statistical impossibility as an occurrence of chance. However, traditional and molecular genetic analyses to date have failed to support the notion of a single gene mutation or identify one, in distinct contrast to medullary carcinoma of the thyroid. Findings to date, outside of distinct multicancer syndromes, suggest the interplay of inherited susceptibility and other factors, such as environmental exposures. It is possible that the main identifiable genetic risk factors at this time are the presence of multinodular goiter or Hashimoto's thyroiditis within the family.     

甲状腺乳头状癌声像图特征探讨

目的：评价甲状腺乳头状癌（papillary thyroid carcinoma,PTC）的声像图特点。方法：回顾性分析34例经手术和病理证实的PTC彩色多普勒超声图像特点。结果：32例（94.1%）低回声,30例（88.2%）结节纵/横≥1,26例（76.5%）伴细微钙化,23例（67.6%）毛剌边缘,29例（85.3%）结节单发,20例（58.8%）边界不清晰,14例（41.2%）侧后方声影,6例（17.6%）检出血流信号,8例（23.5%）颈淋巴结肿大。出现上述异常声像图特征2项以上者占73.5%（25/34）。结论：低回声、微钙化、纵/横≥1、边界、毛剌是PTC具有特征性的超声表现。     

Surgical treatment of papillary thyroid carcinoma

Four hundred and thirty-seven patients with papillary thyroid carcinoma were treated from April 1963 to December 1989. The main treatment was surgery which was divided into 4 types: lobectomy combined with neck dissection (RND or MND); total thyroidectomy; isthmusectomy plus lobectomy; lobectomy combined with RND and then followed by contralateral MND. The 10-year survival rates of these four groups were 88.6%, 89.5% 80% and 80%, respectively. The overall 5, 10 and 15-year survival rates were 92.7%, 87.9%, 79.4%. Lymph node metastasis was present in 80%. The authors believe that functional neck dissection is indicated if the number of lymph node is limited and the size is small.     

Familial occurrence of papillary thyroid carcinoma

The occurrence of familial medullary carcinoma in the thyroid is a well-known entity, but cases of familial papillary carcinoma have been rarely reported. A case of thyroid papillary carcinoma which occurred almost synchronously in a mother and her two daughters is presented. No significant difference between familial and nonfamilial papillary carcinoma was noted in clinical, histopathological and chemical findings. The pedigree of our case is considered to show autosomal dominant inheritance.     

Simultaneous occurrence of medullary carcinoma and papillary carcinoma and papillary carcinoma of the thyroid

We report a case of simultaneous occurrence of medullary carcinoma and papillary carcinoma of the thyroid in the same thyroid gland. Immunoreactivity of calcitonin, carcinoembryonic antigen, neuron specific enolase and thyroglobulin made a sharp distinction between both neoplasms of the thyroid. It appears reasonable to consider that simultaneous occurrence of medullary carcinoma and papillary carcinoma of the thyroid in this case does not have embryological or genetical significance. © 1995 Wiley-Liss, Inc.     

Clinical analysis of prophylactic central neck dissection for papillary thyroid carcinoma

Purpose

The need of prophylactic central neck dissection (PCND) in patients with papillary thyroid carcinoma (PTC) is still controversial. The major restriction of PCND is the potential complications. We undertook a retrospective study to discuss its necessity in PTC patients.

Methods

A total of 188 patients with PTC who underwent total thyroidectomy and PCND were involved. In all of these, central lymph nodes were pathologic examined. Univariate and multivariate analyses were performed based on tumor location and size, etc.

Results

Overall, node metastases were found in 44.1 % (83/188) of patients. Tumor size was the independent positive predictor for lymph node metastasis, while gender, age, tumor multifocality, tumor location, and capsular infiltration were not independent predictors of central lymph node metastases. Postoperative complications happened in 5.3 % (10/188) of patients, which 4.8 % (9/188) had temporary hypocalcemia and 0 % (0/188) had permanent hypocalcemia. Rates of temporary and permanent recurrent laryngeal nerve injury were 0.5 % (1/188) and 0 % (0/188), respectively.

Conclusions

PCND is recommended in all patients with PTC.     

BRAF mutation in papillary thyroid carcinoma

The BRAF gene has been found to be activated by mutation in human cancers, predominantly in malignant melanoma. We tested 476 primary tumors, including 214 lung, 126 head and neck, 54 thyroid, 27 bladder, 38 cervical, and 17 prostate cancers, for the BRAF T1796A mutation by polymerase chain reaction (PCR)-restriction enzyme analysis of BRAF exon 15. In 24 (69%) of the 35 papillary thyroid carcinomas examined, we found a missense thymine (T)-->adenine (A) transversion at nucleotide 1796 in the BRAF gene (T1796A). The T1796A mutation was detected in four lung cancers and in six head and neck cancers but not in bladder, cervical, or prostate cancers. Our data suggest that activating BRAF mutations may be an important event in the development of papillary thyroid cancer.