本帖最后由 小王 于 2016-3-23 09:34 编辑
黑龙江省医院病理科卢艳红 请老师帮忙看看这例：右侧甲状腺肿物，3x2.5x1.5cm，切面灰白色，质硬。
黑龙江祖研医院病理于汀 像腺瘤样改变
湖南省郴州市第一人民医院李苏华 甲状腺乳头状癌
李国霞 乳头状癌
黑龙江祖研医院病理于汀 低倍看是
湘南学院病理科李红全 多级乳头，核膜厚，见核沟，较多核分裂，大量肿瘤性坏死，甲状腺乳头状癌
陈明魁 甲状腺乳头状癌
黑龙江省医院聂明豪 能是转移的吗？
雪花飘飘 支持
FDU肿瘤医院病理◎刘绮颖 会不会是甲状腺乳头状癌，微乳头亚型@黑龙江省医院病理科卢艳红
FDU肿瘤医院病理◎刘绮颖 细胞有点鞋钉样的意思。。
李国霞 Hobnail variant of papillary thyroid carcinoma
黑龙江省医院病理科卢艳红 @FDU肿瘤医院病理◎刘绮颖 嗯，还没确定
李国霞
陕西中医药大学附属医院~王军 @李国霞 甲状腺？
李国霞 Hobnail variant of papillary thyroid carcinoma. Hobnail
PTC is a rare, recently described aggressive variant of PTC that has
prominent hobnail (micropapillary) features. The tumor is composed of
prominent papillae that lack fi brovascular cores, follicles with little colloid,
and clusters of atypical cells with increased nuclear-to- cytoplasmic
ratios and apical nuclei that appear hobnailed [ 76 ]. In the original eight
cases from the Mayo Clinic, six were in women aged 28–78 years
(mean, 58 years) . The tumors were 1–4 cm (mean, 2.5 cm) and
often multifocal. Four of the eight patients died of disease, and two
were alive with disease . In a subsequent series of 24 cases, 18 of 24
were women aged 28–78 years (mean, 57 years), the average follow-up
was 106 months (range, 4–274 months), and tumor sizes ranged from 1
to 5.8 cm (mean, 3 cm) . Of the 24 cases, 12 had <30 % and 12 had
>30 % hobnail component. Six of the 12 with >30 % hobnail component
died of disease, and 3 were alive with extensive disease with a
mean follow-up of 32 months. Of the 12 with <30 % hobnail component,
2 died of disease . These tumors are aggressive, particularly if
>30 % of the tumor is hobnail; however, even in those with less hobnail
component, aggressive behavior may occur
陕西中医药大学附属医院~王军 谢谢分享
FDU肿瘤医院病理◎刘绮颖 @黑龙江省医院病理科卢艳红 期待诊断结果
FDU肿瘤医院病理◎刘绮颖 对于这种hobnail/微乳头亚型的PTC是需要在报告中说明，提示临床医生积极治疗，预后比较差，在American thyroid association 2015版的共识中提到，具有临床指导意义的亚型最好在报告中写出，指导临床医生对病人做治疗和危险度分层的评估
FDU肿瘤医院病理◎刘绮颖 谢谢卢医生分享的病例
本案例根据91360内分泌病理沙龙讨论记录整理 需要加群讨论的请加微信号yanyuemomo或病理程晓军（pathology_cxj）申请。 | 
发表于 2016-3-9 13:49:13
