Hurthle cell carcinoma

na Jason Wasserman MD PhD FRCPC
Machi 26, 2024


Hurthle cell carcinoma is a type of thyroid cancer. It is made up of large pink Hurthle seli. This type of cancer is more likely to develop in older adults and it is rarely seen in children. Pathologists often divide this type of cancer into kidogo vamizi, encapsulated angioinvasive, na widely invasive based on the amount of spread into the surrounding thyroid gland.

This article will help you understand your diagnosis and pathology report for Hurthle cell carcinoma.

Anatomy tezi ya tezi

What are the symptoms of Hurthle cell carcinoma?

Symptoms of Hurthle cell carcinoma may include:

  • Uvimbe au uvimbe kwenye shingo ambayo unaweza kuona au kuhisi.
  • Mabadiliko ya sauti, kama uchakacho.
  • Tatizo la kumeza au kupumua.

What causes Hurthle cell carcinoma?

What causes Hurthle cell carcinoma isn’t fully understood. However, it seems to involve a combination of both genetic changes and environmental risk factors such as exposure to ionizing radiation and dietary influences. This type of cancer is also much more common in young women.

Utambuzi huu unafanywaje?

Utambuzi wa saratani ya seli ya Hurthle inaweza tu kufanywa baada ya tumor nzima kuondolewa na kutumwa kwa mtaalamu wa magonjwa kwa uchunguzi chini ya darubini. Hata hivyo, wagonjwa wengi hufanyiwa upasuaji mdogo unaoitwa a kutamani kwa sindano nzuri (FNAB) kabla ya tumor kuondolewa kabisa. Utaratibu huu hutumia sindano nyembamba sana ili kuondoa kiasi kidogo cha tishu kutoka eneo lisilo la kawaida la tezi ya tezi. Kisha tishu hii inachunguzwa na mtaalamu wa magonjwa chini ya darubini. Biopsy ya FNA hutoa uchunguzi wa awali ambao husaidia kuongoza usimamizi zaidi.

Vipengele vya hadubini

When examined under the microscope Hurthle cell carcinoma is made up of large pink cells called Hurthle seli. Jina hili kimsingi ni jina potofu kwani hizi hazikuwa "seli za Hurthle" zilizoelezewa na Karl Hurthle. Seli ambazo leo tunaziita seli za Hurthle huonekana waridi kwa sababu ya saitoplazimu (mwili wa seli) umejaa sehemu ya seli inayoitwa mitochondria. Seli za Hurthle pia zina duru kubwa kiini (sehemu ya seli inayoshikilia nyenzo za kijenetiki) na sehemu kuu inayojulikana nucleolus (a clump of genetic material in the middle of the nucleus). The Hurthle cells can connect to form small round structures called follicles or they may be in large groups that pathologists describe as a ‘solid pattern’.

Hurthle seli

Encapsulated tumours

Some tumours are surrounded by a thin band of fibrous tissue called a capsule ya tumor. The tumour capsule separates the tumours from the surrounding normal thyroid gland. Examination of the tumour capsule is very important because it helps distinguish Hurthle cell carcinoma from a very similar-looking but non-cancerous tumour called Adenoma ya seli ya Hurthle. In Hurthle cell adenoma, all of the tumour cells are inside the tumour capsule. In contrast, in Hurthle cell carcinoma, tumour cells can be seen crossing the capsule into the surrounding normal thyroid gland tissue. This is called tumour capsule invasion.

Adenoma ya seli ya Hurthle

Hurthle cell carcinoma

Aina za uvamizi

Wataalamu wa magonjwa hutumia neno hilo uvamizi to describe the spread of tumour cells into the surrounding normal thyroid gland. The tumour cells in Hurthle cell carcinoma can show three different patterns of invasion: minimally invasive, encapsulated angioinvasive, and widely invasive. The pattern of invasion is very important because encapsulated angioinvasive and widely invasive tumours are much more likely to spread to other parts of the body.

Mapungufu kidogo

Hurthle cell carcinoma is called minimally invasive when tumour cells have spread through the capsule ya tumor and into the surrounding normal thyroid gland. This type of invasion can only be identified after the tumour is examined under the microscope.

Angioinvasive iliyofunikwa

Hurthle cell carcinoma is called encapsulated angioinvasive when tumour cells are found inside a blood vessel. This process is called uvamizi wa angio. The rest of the tumour is usually still separated from the normal thyroid gland by a capsule ya tumor.

Inavamia sana

Hurthle cell carcinoma inaitwa vamizi kwa wingi wakati uvimbe haujazingirwa na a capsule ya tumor or when only a small area of the capsule remains. The cells in a widely invasive tumour have spread much further into the normal thyroid than the cells in a minimally invasive tumour. In some cases, the spread of tumour cells into the normal thyroid gland can be seen without a microscope during the uchunguzi wa jumla.

Ukubwa wa tumor

Baada ya uvimbe wote kuondolewa, itapimwa na ukubwa wa uvimbe utajumuishwa katika ripoti yako ya ugonjwa. Ukubwa wa uvimbe ni muhimu kwa sababu hutumiwa kuamua hatua ya uvimbe wa patholojia (pT) na kwa sababu uvimbe mkubwa una uwezekano mkubwa wa kuenea kwa sehemu nyingine za mwili.

Angioinvasion (vascular invasion)

Hurthel cell carcinoma is called “angioinvasive” when cancer cells are seen inside a blood vessel. Uvamizi wa Angio is important because it increases the risk that cancer cells will spread to other parts of the body such as the lungs or bones.

If angioinvasion is seen, your pathologist will carefully examine the tumour to determine the number of blood vessels that contain cancer cells.

  • Focal: Tumour cells were seen in LESS than 4 blood vessels.
  • kina: Tumour cells were seen in 4 or MORE blood vessels.

The number of blood vessels involved is important because the risk of developing Metastatic disease is higher when angioinvasion is extensive.

Uvamizi wa lymphatic

Lymphatic invasion is the spread of tumour cells into lymphatic channels (small tubes that move fluid and immune cells around the body). Once tumour cells are inside a lymphatic channel, they can spread to small immune organs called tezi. Kwa sababu hii, uvamizi wa lymphatic huongeza hatari ya kuendeleza lymph node metastasis.

Ugani wa ziada wa tezi

Upanuzi wa Extrathyroidal ni kuenea kwa seli za tumor nje ya tezi ya tezi na ndani ya tishu zinazozunguka. Seli za uvimbe zinazosambaa vya kutosha kutoka kwenye tezi ya tezi zinaweza kugusana na viungo vingine kama vile misuli, umio, au trachea.

Kuna aina mbili za ugani wa extrathyroidal:

  • Hadubini - Seli za uvimbe nje ya tezi zilipatikana tu baada ya uvimbe kuchunguzwa kwa darubini.
  • Macroscopic (jumla) - Uvimbe unaweza kuonekana ukikua ndani ya tishu zinazozunguka bila kutumia darubini. Aina hii ya upanuzi wa ziada ya tezi inaweza kuonekana na daktari wako wa upasuaji wakati wa upasuaji au msaidizi wa mwanapatholojia anayefanya uchunguzi wa kina wa tishu zilizotumwa kwa ugonjwa.

Macroscopic (gross) extrathyroidal ugani ni muhimu kwa sababu huongeza hatua ya tumor ya pathological (pT) na inahusishwa na mbaya zaidi. udhihirisho. On the contrary, microscopic extrathyroidal extension does not change the tumour stage.

Pembezoni

A margin ni tishu ambazo zinapaswa kukatwa na daktari wa upasuaji ili kuondoa tezi kutoka kwa mwili wako. Upeo huchukuliwa kuwa chanya wakati kuna seli za tumor kwenye ukingo wa tishu zilizokatwa. Ukingo hasi unamaanisha kuwa hakukuwa na seli za uvimbe zilizoonekana kwenye ukingo wa tishu.

Marginal

Tezi

Tezi ni viungo vidogo vya kinga vinavyopatikana katika mwili wote. Seli za tumor zinaweza kuenea kutoka kwa tumor ya msingi hadi nodi za lymph kupitia vyombo vidogo vya lymphatic. Kwa sababu hii, nodi za limfu kawaida huondolewa na kuchunguzwa chini ya darubini ili kutafuta seli za saratani. Mwendo wa seli za uvimbe kutoka kwa uvimbe hadi sehemu nyingine ya mwili kama vile nodi ya limfu huitwa a metastasis.

Nodi ya lymph

Seli za uvimbe kawaida huenea kwanza hadi kwenye nodi za limfu karibu na uvimbe ingawa nodi za limfu zilizo mbali na uvimbe pia zinaweza kuhusika. Kwa sababu hii, lymph nodes za kwanza kuondolewa ni kawaida karibu na tumor. Nodi za limfu zilizo mbali zaidi na uvimbe kawaida huondolewa tu ikiwa zimepanuliwa na kuna mashaka ya juu ya kliniki kwamba kunaweza kuwa na seli za saratani kwenye nodi ya limfu.

Upasuaji wa shingo ni utaratibu wa upasuaji unaofanywa ili kuondoa tezi kutoka shingoni. Node za lymph zinazoondolewa kwa kawaida hutoka sehemu tofauti za shingo na kila eneo huitwa ngazi. Viwango kwenye shingo ni pamoja na 1, 2, 3, 4, na 5. Ripoti yako ya ugonjwa mara nyingi itaelezea ni nodi ngapi za lymph zilionekana katika kila ngazi iliyotumwa kwa uchunguzi.

Ikiwa nodi za lymph ziliondolewa kutoka kwa mwili wako, zitachunguzwa chini ya darubini na mwanapatholojia na matokeo ya uchunguzi huu yataelezwa katika ripoti yako. "Chanya" inamaanisha kuwa seli za tumor zilipatikana kwenye nodi ya limfu. "Hasi" inamaanisha kuwa hakuna seli za tumor zilizopatikana. Ikiwa seli za uvimbe zitapatikana kwenye nodi ya limfu, saizi ya kundi kubwa zaidi la seli za uvimbe (mara nyingi hufafanuliwa kama "lengo" au "amana") pia inaweza kujumuishwa kwenye ripoti yako. Ugani wa ziada inamaanisha kuwa seli za uvimbe zimepasua kupitia kibonge cha nje ya nodi ya limfu na kuenea kwenye tishu zinazozunguka.

ugani wa extranodal

Uchunguzi wa lymph nodes ni muhimu kwa sababu mbili. Kwanza, habari hii hutumiwa kuamua hatua ya nodal ya pathological (pN). Pili, kupata seli za tumor kwenye nodi ya limfu huongeza hatari kwamba seli za saratani zitapatikana katika sehemu zingine za mwili katika siku zijazo. Kwa hivyo, daktari wako atatumia maelezo haya anapoamua ikiwa matibabu ya ziada kama vile iodini ya mionzi, chemotherapy, tiba ya mionzi, au tiba ya kinga inahitajika.

Hatua ya Patholojia (pTNM)

​​The pathologic stage for Hurthle cell carcinoma is based on the TNM staging system, an internationally recognized system created by the Kamati ya Pamoja ya Marekani juu ya Saratani. Mfumo huu hutumia habari kuhusu msingi tumor (T), tezi (N), na mbali Metastatic ugonjwa (M) kuamua hatua kamili ya patholojia (pTNM). Mwanapatholojia wako atachunguza tishu zilizowasilishwa na kutoa kila sehemu nambari. Kwa ujumla, idadi kubwa ina maana ugonjwa wa juu zaidi na mbaya zaidi udhihirisho.

Hatua ya tumor (pT)

Hurthle cell carcinoma is given a tumour stage between 1 and 4 based on the size of the tumour and the presence of tumour cells outside of the thyroid.

  • T1 - Uvimbe ni chini ya au sawa na cm 2 na seli za saratani hazienei zaidi ya tezi ya tezi.
  • T2 – Uvimbe ni mkubwa zaidi ya sm 2 lakini chini ya au sawa na sm 4 na seli za saratani hazienei zaidi ya tezi.
  • T3 - uvimbe ni zaidi ya 4 cm OR seli za saratani huenea ndani ya misuli nje ya tezi ya tezi.
  • T4 - Seli za saratani huenea hadi kwa miundo au viungo nje ya tezi ya tezi ikiwa ni pamoja na trachea, larynx, au esophagus.

Hatua ya nodi (pN)

Hurthle cell carcinoma inapewa hatua ya nodi ya 0 au 1 kulingana na uwepo au kutokuwepo kwa seli za tumor katika node ya lymph na eneo la lymph nodes zinazohusika.

  • N0 - Hakuna seli za uvimbe zilizopatikana katika nodi zozote za limfu zilizochunguzwa.
  • N1a Seli za tumor zilipatikana katika nodi za lymph moja au zaidi kutoka kwa kiwango cha 6 au 7.
  • N1b Seli za tumor zilipatikana katika nodi za lymph moja au zaidi kutoka ngazi ya 1 hadi 5.
  • NX - Hakuna nodi za lymph zilizotumwa kwa ugonjwa kwa uchunguzi.

Kuhusu makala hii

Makala hii iliandikwa na madaktari ili kukusaidia kusoma na kuelewa ripoti yako ya ugonjwa. Wasiliana nasi ikiwa una maswali yoyote kuhusu makala hii au ripoti yako ya ugonjwa. Soma makala hii kwa utangulizi wa jumla zaidi wa sehemu za ripoti ya kawaida ya ugonjwa.

Rasilimali nyingine zinazosaidia

Chama cha Tezi cha Marekani (ATA)
Society ya Cancer ya Marekani

Jifunze patholojia zaidi

Atlas ya Patholojia
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