甲状腺結節取り扱い診療 ... - japanthyroid.jp

1 Vol. 1 No. 2 Oct. 201091 Key words thyroid nodule s fine needle aspiration biopsy indeterminate follicular lesion 1 ultrasonography US US 2 50 US 1 US 50 40% 2

2 2006 AACE AME ETA 3 43 ATA 2006 ETA Pacini Schlumberger 11 4 48 AACE/AME/ETA ATA 2007 5 2009 LATS 6 , AACE ATA ETA US FNA 9,600 3 3.

3 000 US FNA 1,000 500 1,000 UCLA 1 Presented by Medical*Online Vol. 1 No. 2 Oct. 201092 15 LATS.

4 9 15 5 6 7 US FNA US FNA US FNA US FNA Indeterminate follicular lesion follicular lesion FNA.

5 Follicular variant type FNA false negative 3 5 1. 1. I.. II.. Presented by Medical*Online Vol. 1 No. 2 Oct. 201093 FNA US FNA FNA false negative 90 98 8 FNA 45 4cm 9 thyroxine T4 TSH

6 TSH 10 TSH 11 TSH T4 T4 TSH . FNA , FNA ATA AACE Bethesda System FNA 10 6 FNA indeterminate ATA 2010 AACE/AME/ETA

7 Indeterminate follicular lesion 2008 National Cancer Institute Bethesda System 6 2. FNA ATA (2009)AACE/AME/ETA(2010)Bethesda System for Reporting thyroid Cytopathology (2009)1. Inadequate Nondiagnostic/ InadequateNondiagnosticNondiagnostic/Uns atisfactory Adequate 2. Normal or benign BenignBenignBenign3. Indeterminate IndeterminateFollicular lesionAtypia of Undetermined Significance/Follicular Lesion of Undetermined Significance (AUS/FLUS) Follicular Neoplasm/Suspicious for a Follicular Neoplasm (FN/SFN)4.

8 Malignancy suspected SuspiciousSuspicious5. Malignancy Diagnostic of or suspicious for PTCM alignantMalignantPresented by Medical*Online Vol. 1 No. 2 Oct. 201094 Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance AUS/FLUS Follicular Neoplasm/Suspicious for a Follicular Neoplasm FN/SFN 2 12 benign follicular neoplasm 5 10 15 30 Bethesda System , FNA.

9 Bethesda System FNA FNA AUS/FLUS FN/SFN Bethesda System . US FNA US US US US US US US 30 1cm 1 US FNA US FNA FNA US ATA US

10 5mm 1cm 2cm AACE/ACE/ETA 1cm FNA 20 5 16 4 29 4