RESUMEN
OBJECTIVE: To establish differential cytologic criteria between benign and malignant thyroid cysts. STUDY DESIGN: The study was a retrospective, transverse, analytic, comparative one of 3 groups of patients with nonfunctional thyroid nodules subjected to fine needle aspiration biopsy (FNAB) and surgical resection of the lesions, with histologic study as the diagnostic gold standard. Fifteen cases of cystic papillary carcinomas (group 1) with initial false negative diagnoses, 42 goiters accompanied by cystic degeneration (group 2) and 15 noncystic papillary carcinomas (group 3) were studied. Independent variables were age and sex; dependent variables were the presence of tridimensional fragments, papillae, anisonucleosis, nuclear bars, pseudoinclusions, powdery chromatin, cytoplasmic vacuoles, metaplastic cytoplasm, psammoma bodies, autolysis, multinucleated giant cells, spindle cells, colloid, monolayered laminae and macrophages in FNAB specimens. Statistical analysis was performed by central tendency measures and the chi 2 test. RESULTS: The chi 2 test revealed a statistically significant difference between group 2 and the groups with papillary carcinoma based on the presence of tridimensional fragments, anisonucleosis, nuclear bars, pseudoinclusions, powdery chromatin, cytoplasmic vacuoles, metaplastic cytoplasm and autolysis. CONCLUSION: The above cytologic characteristics must be searched for systematically in the FNAB of every cystic lesion of the thyroid to rule out the presence of cystic papillary thyroid carcinoma and to decrease the rate of false negative results.
Asunto(s)
Carcinoma Adenoide Quístico/patología , Carcinoma Papilar/patología , Células Epiteliales/patología , Glándula Tiroides/patología , Neoplasias de la Tiroides/patología , Adulto , Anciano , Biopsia con Aguja , Diagnóstico Diferencial , Errores Diagnósticos/prevención & control , Femenino , Bocio/patología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/patología , Reproducibilidad de los Resultados , Estudios RetrospectivosRESUMEN
Se presenta el primer caso de miopatía hipertiroidea en autopsia en el Hospital General de México. Se trata de un hombre de 33 años con enfermedad de Graves-Basedow, quien 30 días antes de su muerte presentó debilidad muscular importante de miembros pélvicos y torácicos, además de disfagia y disfonía. Murió con datos de insuficiencia respiratoria. En los exámenes de laboratorio presentó hipopotasemia. En la autopsia se encontró adelgazamiento, exoftalmos leve, bocio hiperplásico difuso, así como atrofia, infiltración grasa y vacuolación focal en los músculos. Las miopatías relacionadas con hipo e hiperfunción tiroidea son poco frecuentes y recuerdan otras alteraciones musculares primarias y secundarias