KTCC QUIZ (October     2018)   
甲状腺穿刺吸引細胞診 (thyroid FNA)
1.腺腫様結節 2.濾胞性腫瘍 3.乳頭癌 4.低分化癌 5.髄様癌
Which diagnosis is appropriate to choose?
1. Nodular goiter 2. Follicular neoplasm 3. Papillary  carcinoma 4. Poorly differentiated carcinoma 5. Medullary carcinoma
解説(explanatory notes )
答えは「4. 低分化癌」でした。採取細胞量は豊富です。腫瘍細胞は、濾胞状とも乳頭状とも言えない構造で出現しています。右側の写真の細胞集塊は、一見乳頭状にみえますが、内部ではなく、外側に内皮細胞がみえることから、太い索状集塊と思われます。このように、乳頭状パターンも濾胞状パターンも見られない場合には、低分化癌を疑います。
The answer is "4. Poorly differentiated carcinoma." The cellularity is abundant, Tumor cells appear as the structure that is neither follicular nor papillary. The cell cluster in the right photo seems like papillary, but it is actually thick trabecular, because the endothelial cells exist not inside but outside the cluster. Thus, when the cluster which is neither a papillary nor follicular pattern can be seen, suspected poorly differentiated carcinoma is suspected.
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