Dr. Enrique Vicente Greco Greco
Médico Graduado en la Facultad de Medicina de la Universidad de Buenos Aires - Argentina.
sábado, 24 de octubre de 2015
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sábado, 28 de febrero de 2009
Update to the College of American Pathologists Reporting on Thyroid Carcinomas
Head Neck Pathol. 2009 Mar; 3(1): 86–93.
Published online 2009 Feb 28. doi: 10.1007/s12105-009-0109-2
Update to the College of American Pathologists Reporting on Thyroid Carcinomas
Ronald GhosseinAbstract
Background
The reporting of thyroid carcinomas follows the recommendations of the
College of American Pathologists (CAP) protocols and includes papillary
carcinoma, follicular carcinoma, anaplastic carcinoma and medullary
carcinoma. Despite past and recent efforts, there are a number of
controversial issues in the classification and diagnosis of thyroid
carcinomas (TC) that, potentially impact on therapy and prognosis of
patients with TC. Discussion The most updated version of the
CAP thyroid cancer protocol incorporates recent changes in histologic
classification as well as changes in the staging of thyroid cancers as
per the updated American Joint Commission on Cancer staging manual.
Among the more contentious issues in the pathology of thyroid carcinoma
include the defining criteria for tumor invasiveness. While there are
defined criteria for invasion, there is not universal agreement in what
constitutes capsular invasion, angioinvasion and extrathyroidal
invasion. Irrespective of the discrepant views on invasion, pathologists
should report on the presence and extent (focal, widely) of capsular
invasion, angioinvasion and extrathyroidal extension. These findings
assist clinicians in their assessment of the recurrence risk and
potential for metastatic disease. It is beyond the scope of this paper
to detail the entire CAP protocol for thyroid carcinomas; rather, this
paper addresses some of the more problematic issues confronting
pathologists in their assessment and reporting of thyroid carcinomas. Conclusion
The new CAP protocol for reporting of thyroid carcinomas is a step
toward improving the clinical value of the histopathologic reporting of
TC. Large meticulous clinico-pathologic and molecular studies with long
term follow up are still needed in order to increase the impact of
microscopic examination on the prognosis and management of TC.
Keywords: Thyroid,
Carcinoma, Reporting, CAP, Vascular, Capsular, Invasion, Minimally
invasive, Widely invasive, Extrathyroid, Extension, Mitosis, Necrosis,
Margins, Papillary microcarcinomas.
Etiquetas:
CAP,
Capsular,
Carcinoma,
Extension,
Extrathyroid,
Invasion,
Margins,
Minimally invasive,
Mitosis,
Necrosis,
Papillary microcarcinomas.,
Reporting,
Thyroid,
Vascular,
Widely invasive