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Pathologie des Schilddrüsenkarzinoms

Pathology of thyroid cancer

  • Leitthema
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Zusammenfassung

Schilddrüsenkarzinome machen etwa 1% aller menschlichen Malignome aus und stellen somit einen eher seltenen Tumortyp dar. Sowohl die Abgrenzung der Karzinome von gutartigen Läsionen (Hyperplasien, Adenome) als auch die für die weitere Therapie notwendige exakte Klassifizierung der Schilddrüsenkarzinome stellen in der täglichen Routinepathologie mitunter eine diagnostische Herausforderung dar. Schilddrüsenkarzinome mit Follikelzellursprung werden nunmehr auch in der kürzlich erschienenen WHO-Klassifikation der Schilddrüsentumoren aufgrund ihres biologischen Verhaltens in papilläre, follikuläre, gering differenzierte und anaplastische Karzinome unterteilt. Während die differenzierten Karzinome (papilläre und follikuläre Karzinome) ganz überwiegend eine hervorragende Prognose aufweisen, zeigt das gering differenzierte Karzinom eine deutlich schlechtere und das anaplastische Karzinom in der Regel eine infauste Prognose. Das von den C-Zellen ausgehende medulläre Karzinom tritt in einer sporadischen und familiären Form auf. Das familiäre medulläre Karzinom wird autosomal-dominant vererbt und kann heute in fast allen Fällen durch entsprechende Mutationen des RET-Protoonkogens nachgewiesen werden.

Abstract

Thyroid carcinoma accounts for approximately 1% of all human malignancies and is thus a rather rare tumour. Both its differential diagnosis from benign lesions (thyroid hyperplasia and adenoma) and exact classification may cause substantial difficulties in daily routine diagnostic pathology. Due to their different biological behaviour the recently published WHO classification of thyroid tumours subdivides thyroid carcinomas of follicular cell origin into well-differentiated carcinomas (papillary and follicular carcinoma), poorly differentiated carcinomas and anaplastic carcinomas. Whereas papillary and follicular carcinomas are usually associated with good prognosis, poorly differentiated carcinoma shows a significantly less favourable and anaplastic carcinoma even a devastating outcome. Thyroid medullary carcinoma, originating from calcitonin-producing C cells, occurs in a sporadic and familial form; the familial type is inherited in an autosomal dominant manner and shows specific germ line mutations of the RET proto-oncogene.

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Authors and Affiliations

  1. Institut für Pathologie, Universitätsklinikum Essen

    K. W. Schmid, S.-Y. Sheu & M. Tötsch

  2. Westdeutsches Tumorzentrum Essen (WTZE)

    K. W. Schmid, M. Tötsch, A. Bockisch & K. Mann

  3. Klinik für Nuklearmedizin, Universitätsklinikum Essen

    R. Görges & A. Bockisch

  4. Klinik für Endokrinologie, Universitätsklinikum Essen

    K. Mann

  5. Institut für Pathologie, Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen

    K. W. Schmid

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  1. K. W. Schmid
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  2. S.-Y. Sheu
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  3. M. Tötsch
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  4. R. Görges
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Correspondence to K. W. Schmid.

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Schmid, K.W., Sheu, SY., Tötsch, M. et al. Pathologie des Schilddrüsenkarzinoms. Onkologe 11, 29–39 (2005). https://doi.org/10.1007/s00761-004-0811-3

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