Objective: To analyze the clinical and pathological features of nodular goiter combined with thyroid papillary microcarcinoma ( TMC ) . Methods: The clinical and pathological data of 20 nodular goiter combined with thyroid papillary microcarcinoma were retrospective analysed . Results:Among the 20 cases , there were 11 cases were bilateral nodular goiter combined with one side of thyroid papillary microcarcinoma ( TMC ) ,5 cases with the left side of nodular goiter combined with the same side of TMC , 4 cases of the right side of nodular goiter combined with the same side of TMC. In section mass with multiple nodules of different texture, gray brown to gray, the reahn was clear. In mix, TMC nodules, hard texture, gray, grayish yellow, fine granular, ill -defined could be seen, there were varying degrees of fibrosis. Conclusion:Thyroid papillary microcarcinoma and nodular goiter associated with each other. We should pay attention to the clinical and pathological features carefully. When we see obvious interstitial fibrosis but the nipple structure is not apparent, ground glass of the nuclear should cousider the papillary microcarcinoma.%目的:总结结节性甲状腺肿合并甲状腺乳头状微小癌的临床病理特点,为提高病理诊断水平,防止漏诊、误诊提供依据.方法:回顾性分析结节性甲状腺肿合并甲状腺乳头状微小癌的临床病理资料.结果:双侧结节性甲状腺肿伴一侧乳头状微小癌(TMC)11例,左侧结节性甲状腺肿伴左侧TMC5例,右侧结节性甲状腺肿伴右侧TMC4例.肿块切面见不同质地的多发结节,灰棕色至灰白色,境界清楚.其中可见夹杂TMC的结节质地较硬,灰白、灰黄色,细颗粒状,边界不清,有不同程度纤维化.结论:典型的乳头状癌具有纤维血管轴心,被覆大而异型的细胞,排列紊乱,癌细胞核呈毛玻璃样,可见核沟,有时出现核内包涵体.乳头结构不明显时,但见到明显的间质纤维化,毛玻璃样核时要考虑到乳头状微小癌亚型的可能.
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