PAPEL DA ARQUITETURA NUCLEAR NO MANEJO DO <I>(DE LA ARQUITECTURA NUCLEAR EN EL ABORDAJE DEL)</I> CARCINOMA DE TIROIDE

PAPEL DA ARQUITETURA NUCLEAR NO MANEJO DO (DE LA ARQUITECTURA NUCLEAR EN EL ABORDAJE DEL) CARCINOMA DE TIROIDE

(especial para SIIC © Derechos reservados)
O objetivo deste estudo é rever as características nucleares e seu papel no diagnóstico de lesões foliculares da tiroide (es revisar las características nucleares y su papel en el diagnóstico de las lesiones foliculares tiroideas).
Autor:
Rita De Cassia Ferreira
Columnista Experta de SIIC

Institución:
Universidade Estadual de Roraima


Artículos publicados por Rita De Cassia Ferreira
Coautores
Elaine Cristina Morari* Laura Sterian Ward** 
Profesora, Universidade Estadual de Roraima, Roraima, Brasil*
Médica, PhD, Universidade Estadual de Campinas, Campinas, Brasil**
Recepción del artículo
25 de Julio, 2022
Aprobación
25 de Julio, 2022
Primera edición
26 de Julio, 2022
Segunda edición, ampliada y corregida
22 de Noviembre, 2022

Resumen
Um dos maiores dilemas diante de uma lâmina de citopatologia é o diagnóstico diferencial de lesões foliculares da tiroide agrupadas como lesões de padrão folicular e que incluem; bócio, adenoma e carcinoma foliculares, carcinoma papilífero variante folicular e a neoplasia folicular não invasiva com características nucleares papilares (Uno de los mayores dilemas que presenta una muestra de citopatología es el diagnóstico diferencial de las lesiones foliculares tiroideas reunidas como lesiones de patrón folicular, que incluyen: bocio, adenoma folicular, carcinoma folicular, variante folicular del carcinoma papilar y la neoplasia folicular no invasiva con características nucleares de tipo papilar). Tais lesões compartilham muitas características, o que faz com que a identificação adequada de lesões foliculares malignas represente um desafio. A citologia obtida através de punção aspirativa por agulha fina é o método padrão mais efetivo para diagnóstico em nódulos de tiroide, mas sua eficácia diagnóstica diminui nitidamente em lesões de padrão folicular da tiroide (La citología por punción y aspiración con aguja fina es el método estándar más eficaz para el diagnóstico de los nódulos tiroideos, pero su eficacia diagnóstica se ve notablemente reducida en las lesiones de patrón folicular de la tiroides). Assim, uma série de ferramentas auxiliares ao diagnóstico, como a morfometria e a análise de textura nuclear, têm sido utilizadas cada vez mais na prática do patologista, como ferramenta objetiva e reproduzível. São técnicas que dependem da incorporação de softwares para análise digital de imagens e podem agregar acurácia à análise morfológica clássica e à imunohistoquímica na avaliação de lesões de padrão folicular (para el análisis de imágenes digitales y puede agregar precisión al análisis morfológico clásico y la inmunohistoquímica en la evaluación de lesiones de patrón folicular). Somando-se à imunocitoquímica e às técnicas moleculares, a morfometria permite a estimativa de parâmetros identificados em células individuais e representam uma ferramenta que, a partir de parâmetros quantitativos, traduz parâmetros confiáveis para classificação objetiva de malignidade. O objetivo deste estudo é rever as características nucleares e seu papel no diagnóstico de lesões foliculares da tiroide (es revisar las características nucleares y su papel en el diagnóstico de las lesiones foliculares tiroideas).

Palabras clave
citopatología, citopatologia, lesiones foliculares tiroideas, inmunohistoquímica, aspiración con aguja fina, lesões foliculares da tiroide, imunohistoquímica, punção aspirativa por agulha fina


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Abstract
One of the biggest dilemmas facing a cytopathology slide is the differential diagnosis of follicular thyroid lesions, grouped as follicular pattern lesions, which include goiter, follicular adenoma and follicular carcinoma, follicular variant of papillary thyroid carcinoma and non-invasive follicular thyroid neoplasm with papillary like nuclear features. Such lesions share many characteristics, which makes the proper identification of malignant follicular lesions a challenge. The cytology obtained through fine needle aspiration puncture is the most effective standard method for diagnosis of thyroid nodules, but its diagnostic efficacy clearly decreases in lesions of thyroid follicular pattern. Thus, a series of auxiliary tools for diagnoses, such as morphometry and nuclear texture analysis, have been increasingly used in the pathologist's practice, as an objective and reproducible tool. These are techniques, which depend on the incorporation of software to digital image analysis and can add accuracy to classical morphological analysis and immunohistochemistry in the evaluation of follicular pattern lesions. In addition to immunocytochemistry and molecular techniques, morphometry allows the estimation of parameters identified in individual cells and represents a tool that, based on quantitative parameters, translates reliable parameters for objective classification of the malignancy. This study aims to review the nuclear characteristics and their role in the diagnosis of follicular thyroid lesions.

Key words
cytopathology, follicular thyroid lesions, immunocytochemistry, fine needle aspiration puncture


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Genética Humana, Oncología
Relacionadas: Diagnóstico por Imágenes, Endocrinología y Metabolismo, Medicina Nuclear



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Enviar correspondencia a:
Rita de Casiia Ferreira, Universidade Estadual de Roraima, Roraima, Brasil
Bibliografía del artículo
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