KTCC QUIZ (June 2018)   
甲状腺穿刺吸引細胞診 (thyroid FNA)
1.異型腺腫 2.低分化癌 3.未分化癌 4.髄様癌 5.腎癌の転移
Which diagnosis is appropriate to choose?
1. Atypical adenoma  2. Poorly differentiated carcinoma 3. Anaplastic carcinoma 4. Medullary carcinoma 5. Metastatic renal cell carcinoma
解説(explanatory notes )
答えは「1. 異型腺腫」でした。クリーンな背景に、多数の上皮性細胞が濾胞状・充実性に出現しています。細胞および核の大小不同が目立ち、1つの集塊内に小型細胞と大型細胞が混在しています。過染性の巨大核をもった細胞がみられますが、核分裂像や壊死、明瞭な核小体はみられず、未分化癌は否定的です。未分化癌の場合には、背景に多数の好中球やリンパ球が見られることが多いです。
The answer is "1. Atypical adenoma." The background is clean. Many epithelial cells appear as follicular or solid clusters with strong cohesive. The cells vary in size and show anisonucleosis. Small cells and large cells are mixed in the same clusters. There are some atypical cells with huge and hyperchromatic nuclei, however, without prominent nucleoli. There is no mitosis and necrosis. Therefore, the possibility of anaplastic carcinoma might be excluded. In anaplastic carcinoma cases, numerous neutrophils or lymphocytes are frequently seen in the background.