甲状腺乳頭癌と橋本病の鑑別について

概要

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Introduction: Thyroid fine-needle cytology is the first line clinical method for thyroid nodule to select patients for surgery, because papillary carcinoma has diagnostic characteristics in cytology, such as nuclear enlargement, nuclear grooves and nuclear inclusions. However over-diagnosis of Hashimoto disease is well known fact to occur frequently.Materials and Methods: Morphometric analysis of cytological samples from Hashimoto disease, papillary carcinoma and benign adenomatous nodule were carried out 4 cases each using Papanicolaou stained conventional smear samples.Results: Sizes of clusters were evaluated by counting number of follicular cells in the cluster. It was larger in papillary carcinoma (63.3/cluster) and benign (43.9/cluster) than Hashimoto disease (18.9/cluster) (P=0.006). The nuclear diameter increased in Hashimoto disease and the average of the longest diameter was 6.5μm and the shortest was 5.5μm, which was overlapped with those of papillary carcinoma. The number of nuclear grooves increased from benign (<1%), Hashimoto disease (6%) to papillary carcinoma (16%).Conclusion: There are significant overlap between Hashimoto disease and papillary carcinoma morphologically. For more accurate diagnosis of Hashimoto disease may be achieved only with combined morphological features.
神戸常盤大学の論文
2014-03-31