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Ultrasonographic and cytological caracteristics of hyalinizing trabecular adenoma of thyroid gland

ULTRASONOGRAPHIC AND CITOLOGOCAL CARACTERISTICS OF HYALINIZING TRABECULAR ADENOMA OF THYROID GLAND Hyalinizing trabecular adenoma of the thyroid is very rare, cytologicaly hard to recognize. We described two cases and tried to show which ultrasound parameters combined with cytological picture point to this type of tumour. These are cases of middle aged female patients with no palpable enlargement of thyroid and hormones levels within normal range. Ultrasound showed well bordered isoechoic nodule with hypoechoic border and no calcifications within nodule. Aspirate from nodules of both patients on cytological analysis ranged slightly to moderately cellular. The cells were in irregular or dispersed aggregates with fine granules in cytoplasm. Those are characteristics of medullary carcinoma. We also found slightly pleomorphic nuclei, irregular chromatin structure, with some intranuclear cytoplasmic inclusions. Some cells had basophilic, well bordered cytoplasm. There were few psammoma bodies. All that could be interpreted as papillary carcinoma. There were also small aggregates of rosette forming cells with ill-defined, filamentous cytoplasm which is characteristic of follicular carcinoma. Based on former experience in cytology of hyalinizing trabecular adenoma which says that it includes some characteristics of all tree malignant entities of thyroid, combined with ultrasound picture which with high certainty excluded invasive process, we made diagnosis of hyalinizing trabecular adenoma. Patohystological diagnosis, after thyroidectomy, was hyalinizing trabecular adenoma in one case and papilary carcinoma (trabecular type) in other. In conclusion we would like to emphasize that by means of cytology combined with ultrasound, it is possible to make preoperative diagnosis of hyalinizing trabecular thyroid tumour. By most authors hyalinizing trabecular tumour represents one of variants of papillary carcinoma.

ultrasound; thyroid gland; trabecular adenoma

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