Knoten in der Schilddrüse – histologische und zytologische Diagnostik

Zusammenfassung

In Deutschland weisen ca. 25 % der 18- bis 65-Jährigen Knoten > 0,5 cm in der Schilddrüse auf. Das Erkennen von malignen Knoten stellt daher eine besondere klinische Herausforderung dar. In der Dignitätsbeurteilung von Schilddrüsenknoten kommt der Pathologie präoperativ (Feinnadelbiopsie), intraoperativ (Gefrierschnitt) und postoperativ (abschließende histologische Diagnose, gegebenenfalls unter Einschluss der Immunhistochemie und / oder Molekularpathologie) eine tragende Rolle zu. Der vorliegende Artikel fasst die morphologische Differenzialdiagnose des Schilddrüsenknotens unter Berücksichtigung spezieller Aspekte der Feinnadelbiopsie und des intraoperativen Gefrierschnitts der Schilddrüse zusammen.

Abstract

Thyroid nodules (> 0.5 cm) can be found in approximately 25 % of the German population between 18 and 65 years of age. Thus the detection of thyroid malignancy is a tremendous clinical challenge. The pathologist is involved in this task preoperatively (fine-needle biopsy), intraoperatively (frozen section examination), as well as postoperatively (final histological diagnosis, in the case of need including immunohistochemistry and / or molecular pathology). In this review the morphologic differential diagnosis of thyroid nodules is summarized; additionally special aspects of thyroid fine needle biopsy and intraoperative frozen section examination are highlighted.

Schlüsselwörter

Schilddrüsenknoten - Schilddrüsenkarzinom - Feinnadelbiopsie - intraoperativer Gefrierschnitt - Histologie

Key words

thyroid nodule - thyroid carcinoma - fine-needle biopsy - intraoperative frozen section - histology

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