{"id":5977,"date":"2023-03-17T08:42:44","date_gmt":"2023-03-17T08:42:44","guid":{"rendered":"https:\/\/www.eurocytology.eu\/course\/lesiones-foliculares-citologicamente-benignas\/"},"modified":"2023-04-26T09:24:29","modified_gmt":"2023-04-26T09:24:29","slug":"lesiones-foliculares-citologicamente-benignas","status":"publish","type":"course","link":"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-benignas\/","title":{"rendered":"Lesiones foliculares citol\u00f3gicamente benignas"},"content":{"rendered":"<div data-object_id=\"5977\" class=\"cbxwpbkmarkwrap cbxwpbkmarkwrap_guest cbxwpbkmarkwrap_user_cat cbxwpbkmarkwrap-course \"><a  data-redirect-url=\"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course\/5977\/\"  data-display-label=\"1\" data-show-count=\"1\" data-bookmark-label=\"Bookmark\"  data-bookmarked-label=\"Bookmarked\"  data-loggedin=\"0\" data-type=\"course\" data-object_id=\"5977\" class=\"cbxwpbkmarktrig  cbxwpbkmarktrig-button-addto\" title=\"Bookmark This\" href=\"#\"><span class=\"cbxwpbkmarktrig-label\" >Bookmark (<i class=\"cbxwpbkmarktrig-count\">0<\/i>)<\/span><\/a> <div  data-type=\"course\" data-object_id=\"5977\" class=\"cbxwpbkmarkguestwrap\" id=\"cbxwpbkmarkguestwrap-5977\"><div class=\"cbxwpbkmarkguest-message\"><a href=\"#\" class=\"cbxwpbkmarkguesttrig_close\"><\/a><h3 class=\"cbxwpbookmark-title cbxwpbookmark-title-login\">Please login to bookmark<\/h3><form name=\"loginform\" id=\"loginform\" action=\"https:\/\/www.eurocytology.eu\/wp-login.php\" method=\"post\"><p class=\"login-username\">\n\t\t\t\t<label for=\"user_login\">Nombre de usuario o correo electr\u00f3nico<\/label>\n\t\t\t\t<input type=\"text\" name=\"log\" id=\"user_login\" autocomplete=\"username\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-password\">\n\t\t\t\t<label for=\"user_pass\">Contrase\u00f1a<\/label>\n\t\t\t\t<input type=\"password\" name=\"pwd\" id=\"user_pass\" autocomplete=\"current-password\" spellcheck=\"false\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-remember\"><label><input name=\"rememberme\" type=\"checkbox\" id=\"rememberme\" value=\"forever\" \/> Recu\u00e9rdame<\/label><\/p><p class=\"login-submit\">\n\t\t\t\t<input type=\"submit\" name=\"wp-submit\" id=\"wp-submit\" class=\"button button-primary\" value=\"Acceder\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"redirect_to\" value=\"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course\/5977\/\" \/>\n\t\t\t<\/p><\/form><p class=\"cbxwpbookmark-guest-register\">No account yet? <a href=\"https:\/\/www.eurocytology.eu\/es\/register\/?redirect_to=https%3A%2F%2Fwww.eurocytology.eu%2Fes%2Fwp-json%2Fwp%2Fv2%2Fcourse%2F5977%2F\">Register<\/a><\/p><\/div><\/div><\/div><h3>Caracter\u00edsticas citol\u00f3gicas diagn\u00f3sticas&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/h3>\n<ul>\n<li>Baja o moderada celularidad<\/li>\n<li>C\u00e9lulas cohesivas<\/li>\n<li>Patr\u00f3n de predominio microfolicular<\/li>\n<li>C\u00e9lulas foliculares uniformes, regularmente espaciadas.<\/li>\n<li>N\u00facleos redondos, cromatina finamente granular<\/li>\n<li>Citoplasma escaso o moderado<\/li>\n<li>Algunos macr\u00f3fagos<\/li>\n<li>N\u00facleos desnudos<\/li>\n<\/ul>\n<p align=\"justify\">El coloide es usualmente abundante, aparece como gotas amorfas o como una pel\u00edcula delgada transl\u00facida con burbujas y fisuras lineares.<\/p>\n<p align=\"justify\">Algunas lesiones foliculares benignas son hipercelulares y&nbsp; pueden presentar atipia citol\u00f3gica focal. Pueden encontrarse ocasionales c\u00e9lulas alargadas, en forma de huso, representando elementos del estroma reactivo o c\u00e9lulas foliculares alteradas recubriendo \u00e1reas de degeneraci\u00f3n qu\u00edstica. Tambi\u00e9n pueden ocurrir cambios de c\u00e9lulas de Hurtle focales. Si los microfol\u00edculos son escasos y la atipia es focal, se debe realizar un diagn\u00f3stico de un n\u00f3dulo benigno citol\u00f3gicamente, aun si la muestra es celular. Los pacientes con este diagn\u00f3stico tienen que tener un seguimiento a intervalos apropiados.<\/p>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img fetchpriority=\"high\" decoding=\"async\" alt=\"\" height=\"588\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture1_5.jpg\" width=\"625\" \/><\/a><figcaption><strong>A microbiopsy from a nodular goitre.&nbsp;<\/strong>A thick fragment in which round 3D follicles are separated by collagenous stroma. Orangiophilic colloid is visible inside some follicles whose contours are round. Where thinner a monolayer arrangement can be identified.&nbsp;<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img decoding=\"async\" alt=\"\" height=\"950\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture2_4.jpg\" width=\"1267\" \/><\/a><figcaption><strong>Bland thyrocytes in a microfollicular arrangement.&nbsp;<\/strong>A monolayered sheet of bland thyrocytes with bland chromatin and moderate amount of pale, delicate cytoplasm. In the upper corner a follicle lined by similar cells is observed.&nbsp;&nbsp;<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img decoding=\"async\" alt=\"\" height=\"950\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture3_4.jpg\" width=\"1267\" \/><\/a><figcaption><strong>Bare nuclei and microfollicles.&nbsp;<\/strong>Few microfollicles lined by uniform cells with delicate cytoplasm, round nuclei with fine chromatin and surrounded by bare nuclei (MGG).<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"1200\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/369_1425465096.jpg\" width=\"1600\" \/><\/a><figcaption><strong>A very low power view of a cellular lesion.&nbsp;<\/strong>A very lower power view of a MGG stained smear from a follicular lesion. It is very cellular, colloid is not visible and the cells are arranged in sheets, follicles or lie singly. At this magnification no commitment can be made as whether it is benign, suspicious or malignant.&nbsp;<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"1200\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture5.jpg\" width=\"1600\" \/><\/a><figcaption><strong>At high power the cells are uniform.&nbsp;<\/strong>A microfollicular pattern of regular, uniform thyroid cells exhibiting some &#8220;flaring&#8221; at their surface, usually seen in functioning cells; they are also monolayered and no reowding is observed.<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"1200\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture6.jpg\" width=\"1600\" \/><\/a><figcaption><strong>A trabecular arrangement.&nbsp;<\/strong>The same cells may exhibit a trabecular arrangement; in this case the minimal degree of anisonucleosis is well within normal limits. Anisonucleosis (variability in the volume but not the shape of nuclei) is of very little significance in all endocrine glands and is certainly not a criteria for malignancy (MGG).<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"1200\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture7.jpg\" width=\"1600\" \/><\/a><figcaption><strong>Bland, less cohesive thyrocytes.&nbsp;<\/strong>Nuclear detail is better seen in Papanicolaou stain: chromatin is fine and small chromocentres can be seen. Nuclear membrane is regular and thin while cytoplasm is delicate and transparent.<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"1200\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture8.jpg\" width=\"1600\" \/><\/a><figcaption><strong>A cellular aspirate at low power.&nbsp;<\/strong>A medium power view of a microfollicular adenoma (MGG). At this magnification lack of background colloid, uniformity of cells and microfollicular pattern are obvious. In the absence of nuclear atypia, crowding or papillary architecture these lesions are classified differently either as follicular lesion, cytologically benign, Thy3 or follicular lesion &#8211; indeterminate. In all cases the physician must know that criteria to predict a well differentiated follicular carcinoma are only histological following excision of the lesion to search for capsular or vascular invasion. However an aggressive surgical approach will result in many benign lesions being excised. &nbsp;<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"1200\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2004_1425471750.jpg\" width=\"1600\" \/><\/a><figcaption><strong>The cells are uniform and arranged in follicles.&nbsp;<\/strong>The same lesion at higher power confirms lack of nuclear atypia and a dominant microfollicular pattern. Bare nuclei are seen in the background, a feature which is reassuring as it is usually associated with benign lesions.&nbsp;<\/figcaption><\/figure>\n<h3>A microfollicular pattern:<\/h3>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"1200\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture11_0.jpg\" width=\"1600\" \/><\/a><figcaption><strong>A microfollicular pattern.&nbsp;<\/strong>A microfollicular pattern (MGG); cells appear uniform and no crowding is observed, however few discohesive cells maintain their cytoplasm.&nbsp;<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"1200\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2005_1425395384.jpg\" width=\"1600\" \/><\/a><figcaption><strong>A stromal fragment with mesenchymal nuclei.&nbsp;<\/strong>At MGG stroma is pinkish and fibrillary with mesenchymal cells appearing as elongated and usually hyperchromatic nuclei; the thyroid cells maintain a follicular architecture and are not arranged perpendicularly to the stroma as expected in a papillary lesion.&nbsp;<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"1200\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2006_1425395972.jpg\" width=\"1600\" \/><\/a><figcaption><strong>A monolayered sheet of bland thyrocytes.&nbsp;<\/strong>A sheet of monoyared bland thyrocytes surrounded by smaller follicles and bare nuclei.&nbsp;<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"1200\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/2007_1425396329.jpg\" width=\"1600\" \/><\/a><figcaption><strong>A microfollicular arrangement.&nbsp;<\/strong>Bland follicles and bare nuclei.&nbsp;<\/figcaption><\/figure>\n<h3>Adenoma follicular<\/h3>\n<p><span style=\"line-height: 1.72222;\">Esta es una neoplasia benigna, que se presenta como un n\u00f3dulo individual, usualmente no es mayor de 3cm de di\u00e1metro. Algunos de estos pueden producir hormonas tiroideas y consecuentemente causar hipertiroidismo (adenomas funcionales o \u201ccalientes\u201d). El patr\u00f3n histol\u00f3gico puede variar: macrofolicular (compuesto de grandes fol\u00edculos llenos con coloide), microfolicular (con fol\u00edculos mas peque\u00f1os), trabecular (con c\u00e9lulas foliculares organizadas en cintas)<\/span><\/p>\n<h3>Clasificaci\u00f3n (Sin significado pron\u00f3stico)<\/h3>\n<ul>\n<li>Simple<\/li>\n<li>Microfolicular<\/li>\n<li>Trabecular<\/li>\n<li>Oxif\u00edlico<\/li>\n<li>At\u00edpico<\/li>\n<li>Papilar<\/li>\n<li>C\u00e9lulas en anillo de sello<\/li>\n<\/ul>\n<table border=\"1\" cellpadding=\"1\" cellspacing=\"1\" style=\"width: 500px;\">\n<thead>\n<tr>\n<th scope=\"col\" style=\"width: 269px;\">Nodular hyperplasia<\/th>\n<th scope=\"col\" style=\"width: 230px;\">Follicular neoplasia<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"width: 269px;\">multiple<\/td>\n<td style=\"width: 230px;\">solitary<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 269px;\">poorly encapsulated<\/td>\n<td style=\"width: 230px;\">encapsulated<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 269px;\">architectural heterogeneity<\/td>\n<td style=\"width: 230px;\">uniformity of the architecture<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 269px;\">cytologic heterogeneity<\/td>\n<td style=\"width: 230px;\">cytologic homogeneity<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 269px;\">comparable areas in adjacent gland<\/td>\n<td style=\"width: 230px;\">different from surrounding gland<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 269px;\">no compression of surrounding gland<\/td>\n<td style=\"width: 230px;\">compression of surrounding gland<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3>Microfollicular groups:<\/h3>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"675\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture1_6.jpg\" width=\"450\" \/><\/a><figcaption><strong>Microfollicular groups<\/strong>&nbsp;&#8211;&nbsp;These microfollicles are lined by thyrocytes showing a round nucleus with &#8216;open&#8217; chromatin, abundant clear delicate cytoplasm with &#8216;flares&#8217;. These findings are in keeping with functioning cells.&nbsp;<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"494\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture2_5.jpg\" width=\"335\" \/><\/a><figcaption><strong>Microfollicular groups &#8211;&nbsp;<\/strong>This follicular aggregate shows uniform, bland thyrocytes with delicate, clear cytoplasm but no &#8216;flares&#8217;. There is no cytological atypia. A benign follicular lesion may be suggested if the colloid\/cells ratio is low and bare nuclei are present in the background.&nbsp;<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"752\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture3_5.jpg\" width=\"496\" \/><\/a><figcaption><strong>Microfollicular adenoma<\/strong> (histology) &#8211;&nbsp;A low power view of a histologic section of an adenoma which is clearly separated from the surrounding thyroid tissue (Masson Trichrome stain).<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"<div data-object_id=\"5977\" class=\"cbxwpbkmarkwrap cbxwpbkmarkwrap_guest cbxwpbkmarkwrap_user_cat cbxwpbkmarkwrap-course \"><a  data-redirect-url=\"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course\/5977\/\"  data-display-label=\"1\" data-show-count=\"1\" data-bookmark-label=\"Bookmark\"  data-bookmarked-label=\"Bookmarked\"  data-loggedin=\"0\" data-type=\"course\" data-object_id=\"5977\" class=\"cbxwpbkmarktrig  cbxwpbkmarktrig-button-addto\" title=\"Bookmark This\" href=\"#\"><span class=\"cbxwpbkmarktrig-label\" >Bookmark (<i class=\"cbxwpbkmarktrig-count\">0<\/i>)<\/span><\/a> <div  data-type=\"course\" data-object_id=\"5977\" class=\"cbxwpbkmarkguestwrap\" id=\"cbxwpbkmarkguestwrap-5977\"><div class=\"cbxwpbkmarkguest-message\"><a href=\"#\" class=\"cbxwpbkmarkguesttrig_close\"><\/a><h3 class=\"cbxwpbookmark-title cbxwpbookmark-title-login\">Please login to bookmark<\/h3><form name=\"loginform\" id=\"loginform\" action=\"https:\/\/www.eurocytology.eu\/wp-login.php\" method=\"post\"><p class=\"login-username\">\n\t\t\t\t<label for=\"user_login\">Nombre de usuario o correo electr\u00f3nico<\/label>\n\t\t\t\t<input type=\"text\" name=\"log\" id=\"user_login\" autocomplete=\"username\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-password\">\n\t\t\t\t<label for=\"user_pass\">Contrase\u00f1a<\/label>\n\t\t\t\t<input type=\"password\" name=\"pwd\" id=\"user_pass\" autocomplete=\"current-password\" spellcheck=\"false\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-remember\"><label><input name=\"rememberme\" type=\"checkbox\" id=\"rememberme\" value=\"forever\" \/> Recu\u00e9rdame<\/label><\/p><p class=\"login-submit\">\n\t\t\t\t<input type=\"submit\" name=\"wp-submit\" id=\"wp-submit\" class=\"button button-primary\" value=\"Acceder\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"redirect_to\" value=\"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course\/5977\/\" \/>\n\t\t\t<\/p><\/form><p class=\"cbxwpbookmark-guest-register\">No account yet? <a href=\"https:\/\/www.eurocytology.eu\/es\/register\/?redirect_to=https%3A%2F%2Fwww.eurocytology.eu%2Fes%2Fwp-json%2Fwp%2Fv2%2Fcourse%2F5977%2F\">Register<\/a><\/p><\/div><\/div><\/div><p>Caracter\u00edsticas citol\u00f3gicas diagn\u00f3sticas&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Baja o moderada celularidad C\u00e9lulas cohesivas Patr\u00f3n de predominio microfolicular C\u00e9lulas foliculares uniformes, regularmente espaciadas. N\u00facleos redondos, cromatina finamente granular Citoplasma escaso o moderado Algunos macr\u00f3fagos N\u00facleos desnudos El coloide es usualmente abundante, aparece como gotas amorfas o como una pel\u00edcula delgada transl\u00facida con burbujas y fisuras lineares. Algunas lesiones foliculares benignas [&hellip;]<\/p>\n","protected":false},"featured_media":0,"parent":5969,"menu_order":0,"template":"","meta":[],"tags":[],"course_area":[115],"authors":[],"class_list":["post-5977","course","type-course","status-publish","hentry","course_area-citologia-de-tiroides"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Lesiones foliculares citol\u00f3gicamente benignas - Eurocytology<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-benignas\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Lesiones foliculares citol\u00f3gicamente benignas - Eurocytology\" \/>\n<meta property=\"og:description\" content=\"Caracter\u00edsticas citol\u00f3gicas diagn\u00f3sticas&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Baja o moderada celularidad C\u00e9lulas cohesivas Patr\u00f3n de predominio microfolicular C\u00e9lulas foliculares uniformes, regularmente espaciadas. N\u00facleos redondos, cromatina finamente granular Citoplasma escaso o moderado Algunos macr\u00f3fagos N\u00facleos desnudos El coloide es usualmente abundante, aparece como gotas amorfas o como una pel\u00edcula delgada transl\u00facida con burbujas y fisuras lineares. 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