I-angioinvasive oncocytic carcinoma ehlanganisiwe wendlala yegilo

nguJason Wasserman MD PhD FRCPC
Mashi 26, 2024


I-angioinvasive oncocytic carcinoma ehlanganisiwe iwuhlobo lomdlavuza wegilo. Isimila sibizwa ngokuthi “encapsulated” ngoba sihlukanisiwe kokujwayelekile yegilo ndlala ngebhande elincane lethishu elibizwa ngokuthi a isimila capsule. “Angioinvasive” kusho ukuthi amangqamuzana omdlavuza atholakala ngaphakathi okungenani komthambo owodwa wegazi ngaphandle kwesimila. Elinye igama lalolu hlobo lomdlavuza lithi I-angioinvasive Hurthle cell carcinoma ehlanganisiwe.

This article will help you understand your diagnosis and pathology report for encapsulated angioinvasion oncocytic carcinoma.

I-Anatomy ye-thyroid gland

What are the symptoms of encapsulated angioinvasion oncocytic carcinoma?

Symptoms of encapsulated angioinvasive oncocytic carcinoma may include:

  • Isigaxa noma ukuvuvukala entanyeni yakho okwazi ukukubona noma ukukuzwa.
  • Izwi liyashintsha, njengokuhosha.
  • Inkinga yokugwinya noma ukuphefumula.

What causes encapsulated angioinvasion oncocytic carcinoma?

What causes encapsulated angioinvasion oncocytic 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.

Kungani lolu hlobo lomdlavuza lubizwa ngokuthi i-encapsulated?

Oncocytic carcinoma of the thyroid gland is called “encapsulated” when the tumour is separated from the normal thyroid gland by a thin band of tissue called a isimila capsule. Ukuba khona kwe-tumor capsule kubalulekile ngoba kusiza ukuhlukanisa lolu hlobo lomdlavuza nento ehlobene nayo ebizwa i-oncocytic carcinoma ehlasela kakhulu ene-tumor capsule encane kakhulu noma engenawo futhi iningi lamangqamuzana omdlavuza asesabalele endlaleni yegilo evamile ezungezile.

Kungani lolu hlobo lomdlavuza lubizwa ngokuthi i-angioinvasive?

Oncocytic carcinoma of the thyroid gland is called “angioinvasive” when cancer cells are seen inside a blood vessel. I-Angioinvasion 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.

  • Okugxile: Tumour cells were seen in LESS than 4 blood vessels.
  • Kuyandiswa: Tumour cells were seen in 4 or MORE blood vessels.

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

Kwenziwa kanjani lokhu kuxilongwa?

Ukuxilongwa kwe-angioinvasive oncocytic carcinoma ehlanganisiwe kungenziwa kuphela ngemva kokuba isimila sisusiwe futhi sithunyelwe kudokotela wezifo ukuze ahlolwe. Lokhu ngokuvamile kuhilela ukukhipha ngokuhlinzwa i-lobe eyodwa yegland yegilo nakuba ngezinye izikhathi yonke indlala yegilo ikhishwa. Lokhu kuhlonza akukwazi ukwenziwa ngemuva kwenqubo ehlasela kancane ebizwa ngokuthi a i-fine needle aspiration biopsy (FNAB).

Your pathology report for encapsulated angioinvasive oncocytic carcinoma

Your pathology report for encapsulated angioinvasion oncocytic carcinoma will information such as the tumour size, the number of blood vessels involved by the tumour, the presence or absence of extrathyroidal extension, and the assessment of imishado. Imiphumela yanoma iyiphi ama-lymph node okuhloliwe kufanele kufakwe embikweni. Lezi zihloko zichazwe kabanzi ezigabeni ezingezansi.

Izici ze-Microscopic

When examined under the microscope oncocytic thyroid carcinoma is made up of large pink amaseli we-oncocytic. Until very recently, these cells were called Hurthle amaseli. Oncocytic cells appear pink because the icyoplasm (umzimba weseli) ugcwele ingxenye yeselula ebizwa ngokuthi i-mitochondria. Amaseli e-Oncocytic nawo anomjikelezo omkhulu nucleus (ingxenye yeseli ephethe izakhi zofuzo) kanye nendawo emaphakathi evelele i-nucleolus (a clump of genetic material in the middle of the nucleus). The oncocytic cells can connect to form small round structures called follicles or they may be in large groups that pathologists describe as a ‘solid pattern’.

Usayizi wesimila

Ngemuva kokuthi isimila sikhishiwe sonke, sizokalwa futhi nosayizi wesimila uzofakwa embikweni wakho we-pathology. Ubukhulu besimila bubalulekile ngoba sisetshenziselwa ukunquma isigaba se-pathologic tumor (pT) futhi ngenxa yokuthi izimila ezinkulu kungenzeka zisabalele kwezinye izingxenye zomzimba.

Ukuhlasela kwe-lymphatic

Ukuhlasela kwe-lymphatic ukusabalala kwamangqamuzana e-tumor ku-lymphatic channel (amashubhu amancane ahambisa uketshezi kanye namangqamuzana omzimba omzimba emzimbeni). Uma amaseli e-tumor engaphakathi kwesiteshi se-lymphatic, angasakazekela ezithweni ezincane zokuzivikela ezifweni ezibizwa ama-lymph node. Ngenxa yalesi sizathu, ukuhlasela kwe-lymphatic kwandisa ingozi yokuthuthukisa i-lymph node i-metastasis. However, lymphatic invasion is not commonly seen in encapsulated angioinvasive oncocytic carcinoma.

Ukunwetshwa kwe-Extrathyroidal

Isandiso se-Extrathyroidal ukusabalala kwamaseli e-tumor aphuma endlaleni yegilo aye ezicutshini ezizungezile. Amangqamuzana esimila asabalele ngokwanele ngaphandle kwendlala yegilo angase ahlangane nezinye izitho ezinjengemisipha, umminzo, noma uqhoqhoqho.

Kunezinhlobo ezimbili ze-extrathyroidal extension:

  • I-Microscopic - Amaseli e-tumor angaphandle kwegland yegilo atholakala kuphela ngemva kokuhlolwa kwesimila ngaphansi kwe-microscope.
  • I-Macroscopic (gross) – Isimila sibonakala sikhula sibe yizicubu ezisizungezile ngaphandle kokusebenzisa isibonakhulu. Lolu hlobo lwesandiso se-extrathyroidal lungabonwa udokotela wakho ohlinzayo ngesikhathi sokuhlinzwa noma umsizi we-pathologist owenza ukuhlola okujulile kwezicubu ezithunyelwe ku-pathology.

I-Macroscopic (gross) extrathyroidal extension ibalulekile ngoba yandisa i-pathologic tumor stage (pT) futhi ihlotshaniswa nokubi kakhulu. isibikezelo. On the contrary, microscopic extrathyroidal extension does not change the tumour stage.

Amanqamu

A wekhasi izicubu okufanele zisikwe udokotela ohlinzayo ukuze akhiphe indlala yegilo emzimbeni wakho. Imajini ibhekwa njengenhle lapho kunamaseli wesimila emaphethelweni ezicubu ezisikiwe. Umkhawulo ongemuhle usho ukuthi awekho amaseli wesimila abonwe emaphethelweni asikiwe esicubu.

margin

Izindawo ezinama-lymph

Izindawo ezinama-lymph amasosha omzimba amancane atholakala kuwo wonke umzimba. Amangqamuzana e-tumor angasakazeka esuka esimila esiyinhloko aye kuma-lymph nodes ngokusebenzisa imikhumbi emincane ye-lymphatic. Ngenxa yalesi sizathu, ama-lymph nodes avame ukususwa futhi ahlolwe ngesibonakhulu ukuze kubhekwe amangqamuzana omdlavuza. Ukuhamba kwamangqamuzana e-tumor kusuka esimila kuya kwenye ingxenye yomzimba njenge-lymph node kubizwa ngokuthi a i-metastasis.

I-lymph node

Amaseli e-tumor ngokuvamile asakazeka kuqala kuma-lymph nodes eduze kwesimila nakuba ama-lymph nodes akude nesimila nawo angabandakanyeka. Ngenxa yalesi sizathu, ama-lymph nodes okuqala asusiwe ngokuvamile aseduze nesimila. Ama-lymph nodes aqhelelene kakhulu nesimila avame ukususwa kuphela uma ekhulisiwe futhi kukhona izinsolo eziphakeme zomtholampilo zokuthi kungase kube namaseli omdlavuza ku-lymph node.

I-neck dissection iyinqubo yokuhlinzwa eyenziwa ukususa ama-lymph node kusukela entanyeni. Ama-lymph nodes asusiwe ngokuvamile avela ezindaweni ezahlukene zentamo futhi indawo ngayinye ibizwa ngokuthi izinga. Amazinga entanyeni ahlanganisa u-1, 2, 3, 4, kanye no-5. Umbiko wakho we-pathology uzovame ukuchaza ukuthi mangaki ama-lymph nodes abonwe ezingeni ngalinye elithunyelwe ukuze lihlolwe.

Uma noma imaphi ama-lymph node akhishiwe emzimbeni wakho, azohlolwa ngesibonakhulu udokotela wezifo futhi imiphumela yalokhu kuhlolwa izochazwa embikweni wakho. "Positive" kusho ukuthi ama-tumor cells atholakala ku-lymph node. “Okubi” kusho ukuthi awekho amaseli wesimila atholakele. Uma amaseli wesimila etholakala ku-lymph node, usayizi weqembu elikhulu lamaseli wesimila (ngokuvamile okuchazwa ngokuthi “ukugxila” noma “idiphozithi”) nawo angase afakwe embikweni wakho. Isandiso se-Extranodal kusho ukuthi amangqamuzana e-tumor abhodloze i-capsule engaphandle kwe-lymph node futhi asakazeke esicutshini esizungezile.

isandiso se-extranodal

Ukuhlolwa kwama-lymph nodes kubalulekile ngenxa yezizathu ezimbili. Okokuqala, lolu lwazi lusetshenziselwa ukunquma isigaba se-pathologic nodal (pN). Okwesibili, ukuthola amaseli e-tumor ku-lymph node kwandisa ingozi yokuthi amangqamuzana omdlavuza azotholakala kwezinye izingxenye zomzimba esikhathini esizayo. Ngenxa yalokho, udokotela wakho uzosebenzisa lolu lwazi lapho enquma ukuthi kuyadingeka yini ukwelashwa okwengeziwe okufana ne-radioactive iodine, i-chemotherapy, i-radiation therapy, noma i-immunotherapy.

Isigaba se-Pathologic (pTNM)

​​The pathologic stage for encapsulated angioinvasive oncocytic carcinoma is based on the TNM staging system, an internationally recognized system created by the I-American Joint Committee on Cancer. Lolu hlelo lusebenzisa ulwazi mayelana nesimila esiyinhloko (T), ama-lymph node (N), futhi kude i-metastatic isifo (M) ukucacisa isigaba esiphelele se-pathologic (pTNM). I-pathologist yakho izohlola izicubu ezithunyelwe bese inika ingxenye ngayinye inombolo. Ngokuvamile, inani eliphakeme lisho isifo esithuthuke kakhulu futhi esibi kakhulu isibikezelo.

Isiteji se-Tumor (pT)

Encapsulated angioinvasive oncocytic carcinoma is given a tumour stage between 1 and 4 based on the size of the tumour and the presence of cancer cells outside of the thyroid.

  • T1 – Isimila singaphansi noma silingana no-2 cm futhi amangqamuzana omdlavuza awadluleli ngale kwendlala yegilo.
  • T2 – Isimila sikhulu kuno-2 cm kodwa singaphansi noma silingana no-4 cm futhi amangqamuzana omdlavuza awadluleli ngale kwendlala yegilo.
  • T3 - Isimila sikhulu kuno-4 cm OR amangqamuzana omdlavuza adlulela emisipha engaphandle kwegland yegilo.
  • T4 - Amangqamuzana omdlavuza adlulela ezakhiweni noma ezithweni ezingaphandle kwegland yegilo okuhlanganisa uqhoqhoqho, umphimbo, noma umminzo.

Isiteji seNodal (pN)

Encapsulated angioinvasive oncocytic carcinoma is given a nodal stage of 0 or 1 based on the presence or absence of cancer cells in a i-lymph node kanye nendawo yama-lymph nodes ahilelekile.

  • N0 – Awekho amaseli omdlavuza atholakele kunoma yimaphi ama-lymph nodes ahloliwe.
  • N1a - Amangqamuzana omdlavuza atholakala ku-lymph nodes eyodwa noma ngaphezulu kusukela kumazinga 6 noma 7.
  • N1b - Amangqamuzana omdlavuza atholakala ku-lymph nodes eyodwa noma ngaphezulu ukusuka ku-level 1 kuya ku-5.
  • NX - Awekho ama-lymph node athunyelwe ku-pathology ukuze ahlolwe.

Mayelana nalesi sihloko

This article was written by doctors to help you read and understand your pathology report for encapsulated angioinvasive oncocytic carcinoma. The sections above describe the results found in most pathology reports, however, all reports are different and results may vary. Importantly, some of this information will only be described in your report after the entire tumour has been surgically removed and examined by a pathologist. Xhumana nathi uma unemibuzo mayelana nalesi sihloko noma umbiko wakho we-pathology. Funda lesi sihloko ukuze uthole isingeniso esijwayelekile ezingxenyeni zombiko we-pathology ojwayelekile.

Ezinye izinsiza eziwusizo

I-American Thyroid Association (ATA)
I-American Cancer Society

Funda kabanzi nge-pathology

I-atlas ye-Pathology
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