FNAC对弥漫硬化型甲状腺乳头状癌的诊断价值

目的探讨细针穿刺细胞学检查(FNAC)对弥漫硬化型甲状腺乳头状癌(DSV-PTC)的诊断及鉴别价值。方法回顾性分析12例超声可疑DSV-PTC患者,行超声引导下病变区和可疑淋巴结FNAC,并与手术病理及临床随访对照。结果10例经手术证实为DSV-PTC,其中8例伴颈部淋巴结转移;术前甲状腺FNAC正确诊断乳头状癌9例(9/10,90%),1例重复FNAC考虑意义不明确细胞非典型病变,因颈部可疑淋巴结FNAC支持甲状腺转移癌而经手术证实;5例术前同时行异常淋巴结FNAC确诊转移性甲状腺乳头状癌(5/5,100%)。另2例超声疑似患者甲状腺FNAC细胞学病理,分别提示意义不明确细胞非典型病变及淋巴细胞性甲状腺炎,随访3~5年,病情无进展。结论对超声可疑DSV-PTC患者行甲状腺钙化密集区及异常淋巴结FNAC,有助于DSV-PTC的诊断与鉴别,可为临床治疗策略提供依据。

Value of FNAC in Diagnosis of Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma

Objective To investigate the diagnostic value of fine needle aspiration cytology(FNAC)in diffuse sclerosing variant of papillary thyroid carcinoma(DSV-PTC).Methods A retrospective analysis was conducted on 12 patients with suspected DSV-PTC with high-frequency ultrasaund.All patients had ultrasound-guided lesions the results were suspected lymph node FNAC the results were compared with surgical pathology and clinical follow-up.Results 10cases were confirmed by surgical pathology as DSV-PTC,8cases were accompanied cervical lymph node metastasis,a cases were diagnosed as PTC by FNAC before operation(9/10,90%),1case of repeated FNAC was considered to have unclear cell atypical lesion.Suspevted cervical lymph wde FNAC in sapport of motastatic thgroid cancer was sargically confirmed.5cases were diagnosed as metastatic by FNAC before operation(5/5,100%).The other 2 cases were unclear atypical lesions and lymphocytic thyroiditis with thyroid FNAC respectively,they were followed up for 3to 5years,no progress were found.Conclusions In patients with suspected DSV-PTC by high-frequency ultrasound,the FNAC of the area with dense calcification in thyroid and the abnormal lymph node is beneficial to the diagnosis and identification of DSV-PTC and can provide a basis for clinical treatment strategies.