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,光学透明的核,没有染色质链,具有清晰的染色质边缘,比乳头状甲状腺癌的核槽或核内胞浆内含物更具特异性。另外,该特征核特征在低放大倍率下是可检测的。尽管通常在石蜡切片中经常看到这些清晰的核,但在常规处理的接触印记和细针抽吸(FNA)涂片中却看不见它们。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例细胞滤泡性病变和67例结节性增生。我们在所有UFP处理的FNA病例和术中乳头状癌涂片中观察到清晰的细胞核,但其他甲状腺病变未见。透明核在直接接触载玻片的肿瘤细胞中最为明显,而在浸入囊性液体的肿瘤细胞中则未见。在诊断评估中,无论是立即进行现场FNA评估还是在术中会诊之前以及在获得永久性切片之前,UFP是一种在早期诊断评估中检测出孤儿安妮眼状乳头状甲状腺癌的宝贵方法。

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