乳头状癌（四）课件.ppt

Papillary Thyroid CarcinomaPart four Yama Headquarters FNA. Two separate examples of papillary carcinomas with a single cell pattern in aspirates. Gross photograph of a cystic papillary carcinoma. Gross photograph of a unilocular cystic papillary carcinoma bordered by a thick capsule. The patient presented with a cystic neck mass that was aspirated and interpreted as papillary carcinoma. A. Gross photograph . B. Thyroidectomy revealed a large cystic papillary carcinoma. Histologic section of a cystic papillary carcinoma. Note the thick fibrotic capsule. Histologic section of a cystic papillary carcinoma filled with detached papillae, and psammoma bodies. Histologic section of a cystic papillary carcinoma. Thyroid cyst fluid with diagnostic features of papillary carcinoma. Syncytial tissue fragments with intranuclear inclusions. FNA of a cystic papillary carcinoma. A~D. These tissue fragments are syncytial. E. This syncytial tissue fragment of follicular cells show marked vacuolization of the cytoplasm. F. Degenerating follicular cells from nodular goiter. Although the cytoplasm is bubbly, the nuclei are small and very uniform. These histiocytoid cells may cause diagnostic difficulties. G,H. Cystic papillary carcinoma. Note syncytial arrangement of cells and large cytoplasmic vacuoles (Diff-Quik stain). FNA of a cystic papillary carcinoma. The fluid was grossly blood-tinged. A. Against the background of blood and a large number of histiocytes, these three syncytial tissue fragments of follicular cells depict scalloped borders. B,C.Some nuclei contain nucleoli. Inclusions and grooves are not present . Thyroidectomy confirmed papillary carcinoma. Cystic papillary carcinoma. These tissue fragments are composed of large cells with abundant pale, vacuolated to dense cytoplasm. Cystic papillary carcinoma. A. The fluid aspirated from this carcinomaB. A cell block preparation of the sediment A~C. The aspirated fluid from this cystic thyroid lesion was grossly clear.