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目的:探讨包膜内型甲状腺乳头状癌(EPTC)与经典甲状腺乳头状癌(CPTC)的超声及病理特征的差异。方法:对经手术病理确诊的33例EPTC和85例CPTC的超声表现及其病理特征进行对照分析。33例EPTC按照病理组织学成分的不同分为包膜经典乳头型(E-CPTC)21例和包膜滤泡型(E-FVPTC)12例。结果:21例E-CPTC患者的超声表现,肿块边缘成角18例,回声明显减低17例,伴微钙化13例;E-FVPTC组12例中,肿块边缘光整11例,中等回声9例,周边多见晕圈9例,缺乏微钙化12例;CPTC组85例中,肿块形态不规则9例,回声明显减低66例,伴微钙化51例。E-CPTC和E-FVPTC均可见完整的纤维包膜,CPTC未见明显包膜。E-CPTC、E-FVPTC和CPTC癌细胞内均可见乳头状癌特有的细胞核。结论:EPTC组和CPTC组肿块超声表现相似,E-FVPTC组肿块超声显示相对良性的特征。病理组织学表现,E-CPTC和CPTC具有乳头状结构,E-FVPTC癌细胞完全或几乎完全呈滤泡结构。
Objective: To investigate the difference of ultrasonography and pathological features of EPTC and CPTC in patients with papillary thyroid carcinoma (EPTC). Methods: The echocardiographic features and pathological features of 33 EPTC and 85 CPTC confirmed by operation and pathology were analyzed. Thirty-three patients with EPTC were divided into two groups according to the histopathology: E-CPTC (21 cases) and enveloping follicular type (E-FVPTC). Results: The echogenicity of 21 patients with E-CPTC showed that the edge of the tumor was angled in 18 cases, echo was significantly reduced in 17 cases and microcalcification in 13 cases. In E-FVPTC group, 11 cases were found with marginal glossing and 9 cases with moderate echo , Peripheral halo appeared in 9 cases, the lack of microcalcification in 12 cases; CPTC group of 85 cases, the irregular shape of the tumor in 9 cases, echo was significantly reduced 66 cases, with micro-calcification in 51 cases. E-CPTC and E-FVPTC can see the complete fiber capsule, CPTC no obvious capsule. E-CPTC, E-FVPTC and CPTC cancer cells are visible in papillary carcinoma-specific nuclei. CONCLUSIONS: The appearances of the tumors in the EPTC group and the CPTC group are similar, and the sonographic features in the E-FVPTC group are relatively benign. Histopathological findings, E-CPTC and CPTC papillary structures, E-FVPTC cancer cells completely or almost completely follicular structure.