The Orphan Annie-eyed clear nucleus, defined as a large, optically clear nucleus, devoid of chromatin strands, with sharp chromatin rim, is a more specific feature than are nuclear grooves or intranuclear cytoplasmic inclusions in papillary thyroid carcinoma. In addition, this characteristic nuclear feature is detectable at low magnification. Although these clear nuclei are routinely seen in paraffin sections, they are inconspicuously seen in conventionally processed touch-imprints and fine-needle aspiration (FNA) smears. Among our two institutions, there have been 148 thyroid cases processed by Ultrafast Papanicolaou stain (UFP), including 43 papillary carcinomas, 38 cellular follicular lesions, and 67 cases of nodular hyperplasia. We observed clear nuclei in all of the cases of UFP-processed FNA and intraoperative smears of papillary carcinoma but not of other thyroid lesions. The clear nuclei are most evident in tumor cells with direct contact to the glass slide and are not seen in tumor cells soaked in cystic fluid. UFP is a valuable way to detect Orphan Annie-eyed clear nuclei of papillary thyroid carcinoma early in the diagnostic evaluation, either at immediate on-site evaluation of FNA or at intraoperative consultation and before the availability of permanent sections.

译文

孤儿安妮眼透明核,定义为一个大的,光学上透明的核,没有染色质链,具有尖锐的染色质边缘,是比甲状腺乳头状癌中核沟或核内细胞质包涵体更特异的特征。此外,这种特征性核特征在低放大倍率下是可检测到的。尽管这些清晰的核通常在石蜡切片中可见,但在常规处理的触摸印记和细针抽吸 (FNA) 涂片中却不明显。在我们的两个机构中,有148例经超快巴氏染色 (UFP) 处理的甲状腺病例,包括43例乳头状癌,38例细胞滤泡病变和67例结节性增生。我们在所有经UFP处理的FNA病例和乳头状癌的术中涂片中都观察到了清晰的核,但没有观察到其他甲状腺病变。透明的核在与载玻片直接接触的肿瘤细胞中最为明显,在浸泡在囊性液中的肿瘤细胞中未见。UFP是一种有价值的方法,可以在诊断评估的早期,无论是在FNA的现场评估还是在术中咨询以及在永久性切片之前,检测甲状腺乳头状癌的孤儿安妮眼透明核。

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