Abstract：
BACKGROUND: Mesenchymal tumors of the thyroid gland are extremely rare. We report the cytomorphologic characteristics of 12 mesenchymal tumors occurring in the thyroid gland and highlight the diagnostic difficulties encountered in their cytologic evaluation.
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.
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.
摘要：
背景：甲状腺间质瘤极为罕见。我们报告了甲状腺中发生的12例间充质肿瘤的细胞形态学特征，并强调了其细胞学评估中遇到的诊断困难。
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。
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。
