甲状腺疾患における核内封入体の臨床細胞学的検討
1979 年 18 巻 3 号 p. 302-311
詳細
1979 年 18 巻 3 号 p. 302-311
Light microscopic studies were performed to evaluate the intranuclear cytoplasmic inclusions of the thyroid on 102 patients with thyroid disease during the period of from 1971 to 1977. The patients consisted of 35 patients with adenoma, 8 with hyperthyroidism, 5 with chronic thyroiditis, 12 with cyst, 31 with papillary carcinoma, 9 with follicular carcinoma, one with medullary carcinoma and one with anaplastic carcinoma. Normal cytology of the thyroid gland was studied on seven of them.
The following results were obtained.
(1) By the Papanicolaou method the inclusions were stained light bluish or greenish gray, and by the Giemsa method, light reddish-brown. They were mostly round in shape, but were clearly differentiated from degenerative vacuoles for the following features they invariably contained some fine structures and were demarcated by athick and relatively distinct border. By the Papanicolaou, Giemsa, Azan and PAS methods the inclusions were stained in a similar manner to their cytoplasma. By Shorr's and Mann's methods, however, they appeared quite different from nucleoli. The mean diameter of the inclusions was about half a nucleus.
(2) The inclusions were detected in 26 of the 31 patients with papillary carcinoma, one of the 9 patients with follicular carcinoma and one of the one with medullary carcinoma. On the other hand, they were never found in the other histological types of thyroid disease or in the normal thyroid gland in this series.
(3) In the cases of thyroid carcinoma with the inclusions, the ratio of number of carcinoma cells having the inclusions to the number of whole carcinoma cells ranged from 0.48 to 4.01% on the Papanicolaou-stained smears and from 0.29 to 3.87% on the Giemsa-stained smears. The higher this ratio, the more frequently was encountered cellular atypism such as nuclear enlargement, anisonucleosis, abnormal appearance of chromatin, polychromasia of nuclei, nucleolar abnormalities and increased nucleo-cytoplasmic ratio.
(4) It may be concluded that the existence of the inclusions is of significant diagnostic value in indicating malignancy in cytodiagnosis of thyroid disease.
