PDF(Pubmed)
Abstract：
The hobnail variant of papillary thyroid carcinoma (HVPTC) represents a distinctive and relatively rare histological subtype of thyroid malignancies. This variant is characterized by its unique cellular morphology with a hobnail appearance, that is, cells with apically positioned nuclei. There are other characteristics like micropapillary pattern and loss of cohesiveness of cells, which are indicative of HVPTC. It can be difficult to distinguish this pattern from other thyroid neoplasms; thus, a thorough microscopical examination is required. Thyroglobulin, thyroid transcription factor-1 (TTF-1), and other thyroid markers are commonly expressed by the tumor cells. Clinically, HVPTC is similar to conventional papillary thyroid cancer (PTC) in many aspects like incidence and epidemiology, but the former is associated with a worse prognosis. According to some research, the hobnail variety might behave more aggressively than conventional PTC, which highlights how crucial it is to identify and comprehend this distinct subtype. While the genetic and molecular underpinnings of HVPTC are still being elucidated, some studies have reported associations with specific genetic alterations, including BRAF, TP53, and TERT mutations. Investigating these molecular signatures may contribute to a better understanding of the variant\'s pathogenesis and potentially guide targeted therapeutic approaches in the future. In order to customize treatment plans, histopathology is essential in correctly diagnosing it. In this article, we present a case of PTC which presented as a solitary nodule on ultrasonogram in a 40-year-old female.
摘要：
乳头状甲状腺癌（HVPTC）的hobnail变体代表了甲状腺恶性肿瘤的独特且相对罕见的组织学亚型。这种变体的特点是其独特的细胞形态与hobnail外观，也就是说,具有顶端定位的细胞核的细胞。还有其他特征，如微乳头模式和细胞粘结性丧失，这表明了HVPTC。很难将这种模式与其他甲状腺肿瘤区分开来；因此，需要进行彻底的显微镜检查。甲状腺球蛋白,甲状腺转录因子-1(TTF-1),和其他甲状腺标志物通常由肿瘤细胞表达。临床上,HVPTC在发病率和流行病学等许多方面与常规甲状腺乳头状癌（PTC）相似，但前者的预后较差.根据一些研究,hobnail品种可能比传统的PTC表现得更积极，这凸显了识别和理解这种独特亚型的重要性。虽然HVPTC的遗传和分子基础仍在阐明，一些研究报道了与特定遗传改变的关联，包括BRAF,TP53和TERT突变。研究这些分子特征可能有助于更好地理解变异的发病机制，并可能指导未来的靶向治疗方法。为了定制治疗计划，组织病理学是正确诊断的关键。在这篇文章中,我们介绍了一例PTC，在40岁女性的超声检查中表现为孤立性结节。
