METHODS: The cytopathology and surgical pathology archives from 5 large institutions were searched for thyroid mesenchymal tumors that had an FNA available for review. Clinicopathologic and cytomorphologic characteristics for each case were evaluated.
RESULTS: Twelve cases of mesenchymal tumors occurring in the thyroid were identified in our search. Patient age ranged from 28 to 84 years (median, 60 years). The cases occurred in 7 women and 5 men. The tumor size ranged from 1.4 to 14 cm (median, 3.3 cm). The tumors were as follows: hemangioma (n = 4; 33.3%), angiosarcoma (n = 2; 16.7%), schwannoma (n = 2; 16.7%), solitary fibrous tumor (n = 2, 16.7%), metastatic synovial sarcoma (n = 1, 8.3%) and metastatic pleomorphic rhabdomyosarcoma (n = 1, 8.3%). The cytomorphologic features of the tumors were similar to those of their counterparts occurring in different sites. An accurate diagnosis was achieved in six primary thyroid mesenchymal cases (60%). Five patients (41.7%) underwent total thyroidectomy, and 3 patients received partial thyroidectomy (25%). Three patients (25%) did not receive a thyroidectomy and subsequent surgical information was not available in 1 case (8.3%).
CONCLUSIONS: Mesenchymal tumors of the thyroid are extremely uncommon. Cytologic diagnosis of these tumors is often challenging due to the morphologic overlap with diverse epithelial and non-epithelial thyroid lesions. Ancillary studies such as immunohistochemistry and molecular studies are essential for accurate diagnosis.
方法:从5个大型机构的细胞病理学和外科病理学档案中检索具有FNA的甲状腺间质瘤。评估了每个病例的临床病理和细胞形态学特征。
结果:在我们的搜索中发现了12例发生在甲状腺中的间充质肿瘤。患者年龄为28至84岁(中位数,60年)。这些病例发生在7名女性和5名男性中。肿瘤大小为1.4至14厘米(中位数,3.3厘米)。肿瘤如下:血管瘤(n=4;33.3%),血管肉瘤(n=2;16.7%),神经鞘瘤(n=2;16.7%),孤立性纤维瘤(n=2,16.7%),转移性滑膜肉瘤(n=1,8.3%)和转移性多形性横纹肌肉瘤(n=1,8.3%)。肿瘤的细胞形态学特征与发生在不同部位的肿瘤相似。在6例原发性甲状腺间质病例(60%)中获得了准确的诊断。5例患者(41.7%)接受了甲状腺全切除术,3例患者接受部分甲状腺切除术(25%)。3例患者(25%)未接受甲状腺切除术,1例(8.3%)未获得后续手术信息。
结论:甲状腺间质瘤极为少见。由于与各种上皮和非上皮甲状腺病变的形态学重叠,这些肿瘤的细胞学诊断通常具有挑战性。辅助研究如免疫组织化学和分子研究对于准确诊断至关重要。