甲状腺穿刺材料を利用した補助診断
甲状腺穿刺材料を用いた補助診断法について概説する。穿刺針洗浄液を用いた生化学検査，たとえばサイログロブリン，カルシトニン，PTHなどは細胞診よりも診断精度が高く，比較的安価であることから，適応や評価を十分に理解したうえで積極的に用いるべきである。リンパ腫，特にMALTリンパ腫を疑った場合は，フローサイトメトリーによる軽鎖制限の確認は非常に有用である。遺伝子検査は本邦では未だ日常的には行われていないが，今後細胞診で濾胞性腫瘍や意義不明と報告された結節に対して行われていくことになるであろう。...
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| Published in | 日本内分泌・甲状腺外科学会雑誌 Vol. 37; no. 1; pp. 32 - 38 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本内分泌外科学会・日本甲状腺外科学会
2020
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| Subjects | |
| Online Access | Get full text |
| ISSN | 2186-9545 |
| DOI | 10.11226/jaesjsts.37.1_32 |
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| Abstract | 甲状腺穿刺材料を用いた補助診断法について概説する。穿刺針洗浄液を用いた生化学検査，たとえばサイログロブリン，カルシトニン，PTHなどは細胞診よりも診断精度が高く，比較的安価であることから，適応や評価を十分に理解したうえで積極的に用いるべきである。リンパ腫，特にMALTリンパ腫を疑った場合は，フローサイトメトリーによる軽鎖制限の確認は非常に有用である。遺伝子検査は本邦では未だ日常的には行われていないが，今後細胞診で濾胞性腫瘍や意義不明と報告された結節に対して行われていくことになるであろう。 |
|---|---|
| AbstractList | 甲状腺穿刺材料を用いた補助診断法について概説する。穿刺針洗浄液を用いた生化学検査，たとえばサイログロブリン，カルシトニン，PTHなどは細胞診よりも診断精度が高く，比較的安価であることから，適応や評価を十分に理解したうえで積極的に用いるべきである。リンパ腫，特にMALTリンパ腫を疑った場合は，フローサイトメトリーによる軽鎖制限の確認は非常に有用である。遺伝子検査は本邦では未だ日常的には行われていないが，今後細胞診で濾胞性腫瘍や意義不明と報告された結節に対して行われていくことになるであろう。 |
| Author | 工藤, 工 廣川, 満良 鈴木, 彩菜 川木, 裕子 木原, 実 宮内, 昭 宮, 章博 |
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| References | 10. Holmes BJ, Sokoll LJ, Li QK: Measurement of fine-needle aspiration thyroglobulin levels increases the detection of metastatic papillary thyroid carcinoma in cystic neck lesions. Cancer Cytopathol 122: 521-526, 2014 16. Kihara M, Hirokawa M, Kudo T, et al.: Calcitonin measurement in fine-needle aspirate washout fluid by electrochemiluminescence immunoassay for thyroid tumors. Thyroid Res 2018 Oct 30;11:15. doi: 10.1186/s13044-018-0059-4. 13. Haugen BR, Alexander EK, Bible KC, et al.: 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid 26: 1-133, 2016 3. Li QK, Nugent SL, Straseski J, et al.: Thyroglobulin measurements in fine-needle aspiration cytology of lymph nodes for the detection of metastatic papillary thyroid carcinoma. Cancer Cytopathol 121: 440-448, 2013 5. Zhao H, Wang Y, Wang MJ, et al.: Influence of presence/absence of thyroid gland on the cutoff value for thyroglobulin in lymph-node aspiration to detect metastatic papillary thyroid carcinoma. BMC Cancer 17: 296, 2017 22. Hirokawa M, Ayana Suzuki A, Miyauchi A: Thyroid fine-needle aspiration and smearing techniques, VideoEndocrinology 2018, DOI: 10.1089/ve.2018.0119. 1. Pacini F, Fugazzola L, Lippi F, et al.: Detection of thyroglobulin in fine needle aspirates of nonthyroidal neck masses: a clue to the diagnosis of metastatic differentiated thyroid cancer. J Clin Endocrinol Metab 74: 1401-1404, 1992 23. Suzuki A, Hirokawa M, Higashiyama T, et al.: Flow cytometric, gene rearrangement, and karyotypic analyses of 110 cases of primary thyroid lymphoma: a single-institutional experience in Japan. Endocr J 66: 1083-1091, 2019 27. Nishino M, Krane JF: Role of Ancillary Techniques in Thyroid Cytology Specimens. Acta Cytol 64: 40-51, 2020 20. Hirokawa M, Kudo T, Ota H, et al.: Preoperative diagnostic algorithm of primary thyroid lymphoma using ultrasound, aspiration cytology, and flow cytometry. Endocr J 64: 859-865, 2017 21. Stacchini A, Demurtas A, Aliberti S: Extranodal Lymphoproliferative Processes and Flow Cytometry. Acta Cytol 60: 315-325, 2016 26. Cibas ES, Ali SZ: The 2017 Bethesda System for Reporting Thyroid Cytopathology. Thyroid 27: 1341-1346, 2017 8. Tang S, Buck A, Jones C, et al.: The utility of thyroglobulin washout studies in predicting cervical lymph node metastases: One academic medical center's experience. Diagn Cytopathol 44: 964-968, 2016 24. Nakao T, Nishikawa M, Hisakado M, et al.: Characteristics and natural course of hypoechoic thyroid lesions diagnosed as possible thyroid lymphomas by fine needle aspiration cytology. Thyroid Res 11: 8, 2018 6. Uruno T, Miyauchi A, Shimizu K, et al.: Usefulness of thyroglobulin measurement in fine-needle aspiration biopsy specimens for diagnosing cervical lymph node metastasis in patients with papillary thyroid cancer. World J Surg 29: 483-485, 2005 17. Trimboli P, Nigri G, Romanelli F, et al.: Medullary thyroid nodules by measurement of calcitonin (Ct) in aspiration needle washout in patients with multinodular goiter and moderately elevated serum Ct. Exp Clin Endocrinol Diabetes 120: 234-237, 2012 2. Grani G, Fumarola A: Thyroglobulin in lymph node fine-needle aspiration washout: a systematic review and meta-analysis of diagnostic accuracy. J Clin Endocrinol Metab 99: 1970-1982, 2014 15. Suzuki A, Hirokawa M, Takada N, et al.: Fine needle aspiration cytology for medullary thyroid carcinoma: a single institutional experience in Japan. Endocr J 64: 1099-1104, 2017 14. Kudo T, Miyauchi A, Ito Y, et al.: Diagnosis of medullary thyroid carcinoma by calcitonin measurement in fine-needle aspiration biopsy specimens. Thyroid 17: 635-638, 2007 18. Gökçay Canpolat A, Şahin M, Ediboğlu E, et al.: Diagnostic accuracy of parathyroid hormone levels in washout samples of suspicious parathyroid adenomas: A single-centre retrospective cohort study. Clin Endocrinol (Oxf) 89: 489-495, 2018 12. Leenhardt L, Erdogan MF, Hegedus L, et al.: 2013 European thyroid association guidelines for cervical ultrasound scan and ultrasound-guided techniques in the postoperative management of patients with thyroid cancer. Eur Thyroid J 2: 147-159, 2013 25. Lloyd RV, Osamura RY, Kloppel G, et al.: WHO classification of tumours of endocrine organs, Fourth edition, IARC, 2017. 11. 宮内, 昭，高井新一郎，森本茂人他：頚部腫瘤の穿刺吸引鑑別診断，多角的診断記述の応用．日外会誌 84：667-673，1983 19. Doppman JL, Krudy AG, Marx SJ, et al.: Aspiration of enlarged parathyroid glands for parathyroid hormone assay. Radiology 148: 31-35, 1983 7. Trimboli P, D'Aurizio F, Tozzoli R, et al.: Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids. Clin Chem Lab Med 55: 914-925, 2017 4. Boi F, Maurelli I, Pinna G, et al.: Calcitonin measurement in wash-out fluid from fine needle aspiration of neck masses in patients with primary and metastatic medullary thyroid carcinoma. J Clin Endocrinol Metab 92: 2115-2118, 2007 9. Khadra H, Mohamed H, Al-Qurayshi Z, et al.: Superior detection of metastatic cystic lymphadenopathy in patients with papillary thyroid cancer by utilization of thyroglobulin washout. Head Neck 41: 225-229, 2019 |
| References_xml | – reference: 5. Zhao H, Wang Y, Wang MJ, et al.: Influence of presence/absence of thyroid gland on the cutoff value for thyroglobulin in lymph-node aspiration to detect metastatic papillary thyroid carcinoma. BMC Cancer 17: 296, 2017 – reference: 7. Trimboli P, D'Aurizio F, Tozzoli R, et al.: Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids. Clin Chem Lab Med 55: 914-925, 2017 – reference: 25. Lloyd RV, Osamura RY, Kloppel G, et al.: WHO classification of tumours of endocrine organs, Fourth edition, IARC, 2017. – reference: 2. Grani G, Fumarola A: Thyroglobulin in lymph node fine-needle aspiration washout: a systematic review and meta-analysis of diagnostic accuracy. J Clin Endocrinol Metab 99: 1970-1982, 2014 – reference: 1. Pacini F, Fugazzola L, Lippi F, et al.: Detection of thyroglobulin in fine needle aspirates of nonthyroidal neck masses: a clue to the diagnosis of metastatic differentiated thyroid cancer. J Clin Endocrinol Metab 74: 1401-1404, 1992 – reference: 6. Uruno T, Miyauchi A, Shimizu K, et al.: Usefulness of thyroglobulin measurement in fine-needle aspiration biopsy specimens for diagnosing cervical lymph node metastasis in patients with papillary thyroid cancer. World J Surg 29: 483-485, 2005 – reference: 26. Cibas ES, Ali SZ: The 2017 Bethesda System for Reporting Thyroid Cytopathology. Thyroid 27: 1341-1346, 2017 – reference: 24. Nakao T, Nishikawa M, Hisakado M, et al.: Characteristics and natural course of hypoechoic thyroid lesions diagnosed as possible thyroid lymphomas by fine needle aspiration cytology. Thyroid Res 11: 8, 2018 – reference: 22. Hirokawa M, Ayana Suzuki A, Miyauchi A: Thyroid fine-needle aspiration and smearing techniques, VideoEndocrinology 2018, DOI: 10.1089/ve.2018.0119. – reference: 13. Haugen BR, Alexander EK, Bible KC, et al.: 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid 26: 1-133, 2016 – reference: 3. Li QK, Nugent SL, Straseski J, et al.: Thyroglobulin measurements in fine-needle aspiration cytology of lymph nodes for the detection of metastatic papillary thyroid carcinoma. Cancer Cytopathol 121: 440-448, 2013 – reference: 23. Suzuki A, Hirokawa M, Higashiyama T, et al.: Flow cytometric, gene rearrangement, and karyotypic analyses of 110 cases of primary thyroid lymphoma: a single-institutional experience in Japan. Endocr J 66: 1083-1091, 2019 – reference: 14. Kudo T, Miyauchi A, Ito Y, et al.: Diagnosis of medullary thyroid carcinoma by calcitonin measurement in fine-needle aspiration biopsy specimens. Thyroid 17: 635-638, 2007 – reference: 4. Boi F, Maurelli I, Pinna G, et al.: Calcitonin measurement in wash-out fluid from fine needle aspiration of neck masses in patients with primary and metastatic medullary thyroid carcinoma. J Clin Endocrinol Metab 92: 2115-2118, 2007 – reference: 11. 宮内, 昭，高井新一郎，森本茂人他：頚部腫瘤の穿刺吸引鑑別診断，多角的診断記述の応用．日外会誌 84：667-673，1983 – reference: 19. Doppman JL, Krudy AG, Marx SJ, et al.: Aspiration of enlarged parathyroid glands for parathyroid hormone assay. Radiology 148: 31-35, 1983 – reference: 8. Tang S, Buck A, Jones C, et al.: The utility of thyroglobulin washout studies in predicting cervical lymph node metastases: One academic medical center's experience. Diagn Cytopathol 44: 964-968, 2016 – reference: 17. Trimboli P, Nigri G, Romanelli F, et al.: Medullary thyroid nodules by measurement of calcitonin (Ct) in aspiration needle washout in patients with multinodular goiter and moderately elevated serum Ct. Exp Clin Endocrinol Diabetes 120: 234-237, 2012 – reference: 12. Leenhardt L, Erdogan MF, Hegedus L, et al.: 2013 European thyroid association guidelines for cervical ultrasound scan and ultrasound-guided techniques in the postoperative management of patients with thyroid cancer. Eur Thyroid J 2: 147-159, 2013 – reference: 10. Holmes BJ, Sokoll LJ, Li QK: Measurement of fine-needle aspiration thyroglobulin levels increases the detection of metastatic papillary thyroid carcinoma in cystic neck lesions. Cancer Cytopathol 122: 521-526, 2014 – reference: 21. Stacchini A, Demurtas A, Aliberti S: Extranodal Lymphoproliferative Processes and Flow Cytometry. Acta Cytol 60: 315-325, 2016 – reference: 15. Suzuki A, Hirokawa M, Takada N, et al.: Fine needle aspiration cytology for medullary thyroid carcinoma: a single institutional experience in Japan. Endocr J 64: 1099-1104, 2017 – reference: 20. Hirokawa M, Kudo T, Ota H, et al.: Preoperative diagnostic algorithm of primary thyroid lymphoma using ultrasound, aspiration cytology, and flow cytometry. Endocr J 64: 859-865, 2017 – reference: 27. Nishino M, Krane JF: Role of Ancillary Techniques in Thyroid Cytology Specimens. Acta Cytol 64: 40-51, 2020 – reference: 18. Gökçay Canpolat A, Şahin M, Ediboğlu E, et al.: Diagnostic accuracy of parathyroid hormone levels in washout samples of suspicious parathyroid adenomas: A single-centre retrospective cohort study. Clin Endocrinol (Oxf) 89: 489-495, 2018 – reference: 9. Khadra H, Mohamed H, Al-Qurayshi Z, et al.: Superior detection of metastatic cystic lymphadenopathy in patients with papillary thyroid cancer by utilization of thyroglobulin washout. Head Neck 41: 225-229, 2019 – reference: 16. Kihara M, Hirokawa M, Kudo T, et al.: Calcitonin measurement in fine-needle aspirate washout fluid by electrochemiluminescence immunoassay for thyroid tumors. Thyroid Res 2018 Oct 30;11:15. doi: 10.1186/s13044-018-0059-4. |
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| Title | 甲状腺穿刺材料を利用した補助診断 |
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