{"id":5978,"date":"2023-03-17T08:42:44","date_gmt":"2023-03-17T08:42:44","guid":{"rendered":"https:\/\/www.eurocytology.eu\/course\/lesiones-foliculares-citologicamente-sospechosas\/"},"modified":"2023-04-26T09:24:29","modified_gmt":"2023-04-26T09:24:29","slug":"lesiones-foliculares-citologicamente-sospechosas","status":"publish","type":"course","link":"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/","title":{"rendered":"Lesiones foliculares citol\u00f3gicamente sospechosas"},"content":{"rendered":"<div data-object_id=\"5978\" class=\"cbxwpbkmarkwrap cbxwpbkmarkwrap_guest cbxwpbkmarkwrap_user_cat cbxwpbkmarkwrap-course \"><a  data-redirect-url=\"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course\/5978\/\"  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=\"5978\" 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=\"5978\" class=\"cbxwpbkmarkguestwrap\" id=\"cbxwpbkmarkguestwrap-5978\"><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\/5978\/\" \/>\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%2F5978%2F\">Register<\/a><\/p><\/div><\/div><\/div><h3>Caracter\u00edsticas citol\u00f3gicas diagn\u00f3sticas<\/h3>\n<ul>\n<li>Alta celularidad<\/li>\n<li>Patr\u00f3n predominantemente microfolicular o trabecular<\/li>\n<li>Api\u00f1amiento, superposici\u00f3n de c\u00e9lulas<\/li>\n<li>Alteraciones celulares (atipia leve, aumento uniforme de tama\u00f1o)<\/li>\n<li>Escaso coloide o ausencia de coloide<\/li>\n<\/ul>\n<p align=\"justify\">Varias de estas caracter\u00edsticas deben estar presentes para diagnosticar una lesi\u00f3n folicular como \u201ccitol\u00f3gicamente sospechosa\u201d. Es poco com\u00fan encontrar marcada atipia celular, o mitosis. Los macr\u00f3fagos estan ausentes. Los n\u00facleos desnudos son inusuales o est\u00e1n ausentes.<\/p>\n<p align=\"justify\">Hay un criterio \u00fanico suficiente para diferenciar los n\u00f3dulos benignos de los sospechosos. La presencia de varias de estas caracter\u00edsticas aumenta la probabilidad de malignidad, y en este caso se debe hacer el diagn\u00f3stico de n\u00f3dulos foliculares citol\u00f3gicamente sospechosos. Todos los aspirados que est\u00e1n compuestos por una poblaci\u00f3n \u00fanica de c\u00e9lulas de Hurthle son sospechosos por definici\u00f3n.<\/p>\n<p align=\"justify\">El diagn\u00f3stico diferencial incluye otras neoplasias de tiroides. Las hendiduras nucleares y pseudoinclusiones pueden estar presentes de manera focal en algunos adenomas foliculares y carcinomas. Si es focal, estos no deben llevar a un diagn\u00f3stico de carcinoma papilar pero deben definir la lesi\u00f3n como sospechosa. En los llamados adenomas trabeculares hialinizados, los frotis muestran c\u00e9lulas ovales o en forma de huso en agregados o aisladas. Pistas para el diagn\u00f3stico correcto son la formaci\u00f3n de c\u00e9lulas en espiral o en series paralelas y el material hialino amorfo y la zona clara perinuclear (halos). La variante de c\u00e9lulas claras del carcinoma folicular puede ser confundida con algunos de los tumores de paratiroides o el carcinoma metast\u00e1tico de c\u00e9lulas renales, pero las c\u00e9lulas son usualmente positivas con inmunotinciones para tiroglobulina.<\/p>\n<p align=\"justify\">Cerca de un 30% a 40% de los casos diagnosticados como \u201cn\u00f3dulos foliculares sospechosos\u201d son confirmados como malignos. Entre estos, solo un 50% a 75% son carcinomas foliculares, mientras que los otros son confirmados como variantes foliculares del carcinoma papilar.<\/p>\n<p align=\"justify\">La clasificaci\u00f3n Thy ha sido dise\u00f1ada cl\u00ednicamente para separar las lesiones de alto riesgo de malignidad de aquellas que tienen bajo riesgo. En ambos casos, el cirujano ofrecer\u00e1 la escisi\u00f3n del n\u00f3dulo pero remarcar\u00e1 que en la primera (Categor\u00eda thy 4) el riesgo es de un 80% aproximadamente mientras que la \u00faltima (Thy3) es de aproximadamente un 20%. En pacientes con un diagn\u00f3stico de \u201cn\u00f3dulo folicular sospechoso\u201d la lobectom\u00eda es usualmente llevada a cabo; si se diagnostica carcinoma en el an\u00e1lisis histol\u00f3gico, se recomienda la tiroidectom\u00eda completa.&nbsp;<\/p>\n<p align=\"justify\">Se han recomendado las t\u00e9cnicas adjuntas para diferenciar entre lesiones foliculares benignas y sospechosas. Los an\u00e1lisis morfol\u00f3gicos y de im\u00e1genes han demostrado no ser lo suficientemente precisos para los prop\u00f3sitos cl\u00ednicos. Las mediciones de DNA mediante la citometr\u00eda de flujo tampoco son \u00fatiles; de hecho, la aneuploid\u00eda no garantiza que un tumor sea maligno. La inmunohistoqu\u00edmica para MIB-1 no es de gran valor, puesto que la actividad proliferativa en los adenomas y carcinomas puede ser similar. La inmunohistoqu\u00edmica para galectin-3 parece ser prometedor en la pr\u00e1ctica cl\u00ednica. La diferenciaci\u00f3n&nbsp; se puede hacer con marcadores gen\u00e9ticos: la translocaci\u00f3n t(2;3) es un marcador espec\u00edfico para el carcinoma folicular.&nbsp;<\/p>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img fetchpriority=\"high\" decoding=\"async\" alt=\"\" height=\"738\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture1_7.jpg\" width=\"484\" \/><\/a><figcaption>Nuclei showing a coarse chromatin pattern and nuclear grooving. A follicular lesion with nuclei showing a coarser chromatin pattern and nuvlear grooving.<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img decoding=\"async\" alt=\"\" height=\"503\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture11.jpg\" width=\"670\" \/><\/a><figcaption>The same lesion confirming a coarsely granular chromatin, mild nuclear pleomorphism. A high power view showing a coarsely granular chromatin and mild nuclear pleomorphism. Although there is some nuclear overlapping this feature is not so reliable in thicker clusters of cells.<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img decoding=\"async\" alt=\"\" height=\"503\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture22.jpg\" width=\"670\" \/><\/a><figcaption>Cells exhibiting some crowding, mild pleomorphism and irregular chromatin &#8211; &nbsp;An MGG stain showing a microfollicular pattern with cells exhibiting some crowding, mild pleomorphism and a more irregularly granular chromatin.<\/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\/Picture2_1.jpg\" width=\"1600\" \/><\/a><figcaption>Changes can be very focal and admixed with otherwise unremakable areas.&nbsp;This a rather bland follicle; in suspicous follicular lesions changes can be very focal and admixed with otherwise unremakable areas.<\/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\/2008_1425463170.jpg\" width=\"1600\" \/><\/a><figcaption>A rather crowded group of thyrocytes showing mild pleomorphism.&nbsp;A rather crowded group of thyrocytes showing mild pleomorphism; although a follicular arrangement can be identified nuclei are overlapping thoughout the group. This does not appear to be dictated by thickness of the cluster but is rather an expression of a more disordered architecture.<\/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\/Picture4_0.jpg\" width=\"1600\" \/><\/a><figcaption>A nuclear pseudoinclusion in one cells and a flake of dense colloid. A monolayered sheet of thyroid cells which appear uniform, however a nuclear pseudoinclusion is visible in one cell and a flake of dense colloid is present at the upper right corner of the field (MGG); these would qualify the lesion as suspicious. Elsewhere more obvious features of papillary carcinoma, follicular variant were present.<\/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_0.jpg\" width=\"1600\" \/><\/a><figcaption>A crowded group with prominent nucleoli and obvious nuclear grooves.&nbsp;A group of overlapping thyroid cells with prominent nucleoli and obvious nuclear grooves (Pap) in a blood stained smear. These features are suspicious but quantitatively insufficient for a definitive diagnosis of malignancy: other findings must be present.<\/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\/2009_1425469213.jpg\" width=\"1600\" \/><\/a><figcaption>Two similar groups of thryoid cells with prominent nucleolus and mild nuclear pleomorphism. Two groups of thryoid cells with prominent nucleolus and mild nuclear pleomorphism.<\/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_0.jpg\" width=\"1600\" \/><\/a><figcaption>Nuclear overlapping in the upper left corner of the fragment.&nbsp;This lower power view of a Papanicolaou stained microbiopsy still identifies sheets of monolayered uniform thyroid cells which elsewhere showed suspicious nuclear features. You may note the more disordered architecture with nuclear overlapping in the upper left corner of the fragment. This low power finding should prompt an accurate screening of the slides for confirmation of suspicious features, this architectural feature alone being insufficient for diagnosis of suspicion.<\/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_0.jpg\" width=\"1600\" \/><\/a><figcaption>A group of cells with marked anisonucleosis.&nbsp;A high power view of an MGG stained smear showing a group of cells with marked anisonucleosis, again a finding which should prompt a thorough search for more diagnostic features of suspicion for malignancy.<\/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\/2010_1425478031.jpg\" width=\"1600\" \/><\/a><figcaption>A central nucleus is much larger, hyperchromatic and has an irregular contour. A group of thyrocytes: a central nucleus is much larger, hyperchromatic and has an irregular contour (MGG). This is a suspicious finding.<\/figcaption><\/figure>\n<h3>Carcinoma folicular<\/h3>\n<p align=\"justify\">Representa el segundo c\u00e1ncer m\u00e1s com\u00fan de la tiroides (5% a 15% de las lesiones malignas de tiroides). Es usualmente un n\u00f3dulo solitario, pero a diferencia del adenoma folicular, este muestra infiltraci\u00f3n capsular e invasi\u00f3n vascular. El carcinoma folicular se divide usualmente en dos subtipos histol\u00f3gicos: m\u00ednimamente invasivo con un pron\u00f3stico muy bueno y el extensamente invasivo con pron\u00f3stico muy pobre, que tiende a dar met\u00e1stasis a pulmones y huesos.&nbsp;<\/p>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"569\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture1_8.jpg\" width=\"379\" \/><\/a><figcaption>An MGG stain of an FNA from a follicular carcinoma.&nbsp;This case was mistakenly thought to be a medullary carcinoma because of the presence of cytoplasmic granules; it proved to be a follicular carcinoma. The granules are not the fine metachromatic ones found in medullary carcinoma and probably represent lysosomes. In our experience the vast majority of follicular carcinomas are labelled as suspicious follicular lesions.<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"469\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture2_6.jpg\" width=\"310\" \/><\/a><figcaption>Groups of thyrocytes from a follicular carcinoma.<\/figcaption><\/figure>\n<h2>&nbsp;<\/h2>\n<h3>Tumores de las c\u00e9lulas de Hurtle<\/h3>\n<p align=\"justify\">Las c\u00e9lular de Hurtle (oncocitos) son c\u00e9lulas foliculares alteradas que tienen numerosas mitocondrias. En los frotis citol\u00f3gicos, aparecen como c\u00e9lulas poligonales, con un citoplasma amplio y finamente granular, de color p\u00farpura en la tinci\u00f3n MGG y naranjofilo con la tinci\u00f3n de Papanicolaou. Estas c\u00e9lulas pueden ser binucleadas, tener los n\u00facleos grandes,&nbsp; y ser de tama\u00f1os variables, frecuentemente poseen nucleolos prominentes.<\/p>\n<p align=\"justify\">Las c\u00e9lulas de Hurtle son comunes en la tiroiditis de Hashimoto y en el bocio multinodular, donde pueden formar n\u00f3dulos macrosc\u00f3picos. Las c\u00e9lulas de Hurtle benignas son usualmente cohesivas y carecen de nucleolos prominentes; a veces puede encontrarse un leve o moderado pleomorfismo. <strong>En la tiroiditis de Hashimoto, est\u00e1n mezcladas con numerosos linfocitos. En el bocio nodular, est\u00e1n mezcladas con macr\u00f3fagos y coloide.<\/strong><strong> <\/strong><\/p>\n<p align=\"justify\">En los tumores de c\u00e9lulas de Hurtle los aspirados est\u00e1n generalmente compuestos de una poblaci\u00f3n de c\u00e9lulas de Hurtle puras. Las c\u00e9lulas son usualmente dispersas, pero pueden verse algunos agregados. Frecuentemente se encuentran n\u00facleos vesiculares y nucleolos prominentes. En el caso de la neoplasia de c\u00e9lulas de Hurtle, las c\u00e9lulas foliculares normales no est\u00e1n presentes al igual que los abundantes linfocitos; puede verse coloide.<\/p>\n<p align=\"justify\">El diagn\u00f3stico diferencial incluye algunas variantes del carcinoma papilar, tales como c\u00e9lula alta\/rosa y oncoc\u00edtica. M\u00e1s aun, rara vez los tumores de c\u00e9lulas de Hurtle muestran arquitectura papilar (neoplasia papilar oncoc\u00edtica). Las variantes del carcinoma papilar pueden excluirse por la ausencia de las caracter\u00edsticas nucleares t\u00edpicas en casi todos los casos. Los carcinomas metast\u00e1ticos de c\u00e9lulas renales pueden simular las neoplasias de c\u00e9lulas de Hurtle, pero la inmunocitoqu\u00edmica para factor de trascripci\u00f3n tiroideo 1 (TTF-1) que es positivo en las c\u00e9lulas de Hurtle y foliculares, es negativo en las c\u00e9lulas del carcinoma de c\u00e9lulas renales. El carcinoma medular de tiroides muestra un patr\u00f3n de c\u00e9lulas dispersas y una apariencia citol\u00f3gica que puede imitar la neoplasia de c\u00e9lulas de Hurtle. Los nucleolos prominentes est\u00e1n ausentes en el carcinoma medular. Con la tinci\u00f3n de MGG, los gr\u00e1nulos de las c\u00e9lulas de Hurtle son azules, los de las c\u00e9lulas del carcinoma medular son rojos.<\/p>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"801\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture1_9.jpg\" width=\"564\" \/><\/a><figcaption>A low power view of a <strong>FNA from a H\u00fcrthle cell neoplasm<\/strong> (MGG).&nbsp;<strong>A pure population of H\u00fcrthle cells<\/strong> (MGG). Note the pleomorphism which is apparent even at low power; this is not diagnostic of malignancy as it is a common feature in these neoplasms, whether benign or malignant. In our experience it is rather monomorphism which is more commonly associated with malignancy. In all cases definitive criteria for malignancy are exclusively histological (capsular or vascular invasion).&nbsp;<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"456\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture4_3.jpg\" width=\"301\" \/><\/a><figcaption><strong>A group of rather pleomorphic H\u00fcrthle cell <\/strong>(Pap).&nbsp;The pleomorphism is striking, with very large nuclei, prominent nucleoli and multinucleations. The N\/C ratio however is not high.&nbsp;<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"456\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture5_1.jpg\" width=\"306\" \/><\/a><figcaption><strong>A follicular group of H\u00fcrthle cells<\/strong> (Pap). A cohesive group of cells showing the typical features of H\u00fcrthle cells (Pap). Note the dense cytoplasm with well defined borders, vescicular nuclei and prominent nucleoli.<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"396\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture2_7.jpg\" width=\"591\" \/><\/a><figcaption><strong>Discohesive H\u00fcrthle cells (Pap).<\/strong> Discohesive cells with marked pleomorphism but preserved N\/C ratio. Cytoplasm is dense and nuclei are round, often eccentrically placed imparting a &#8220;plasmacytoid&#8221; appearance. This may mimic medullary carcinoma.<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"503\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture19.jpg\" width=\"670\" \/><\/a><figcaption><strong>A rather pleomorphic collection of H\u00fcrthle cells<\/strong> (MGG)&nbsp;showing pleomorphic nuclei, nucleoli and dense cytoplasm, often containing coarse granules. These are different from the fine granularity of medullary carcinoma.<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"<div data-object_id=\"5978\" class=\"cbxwpbkmarkwrap cbxwpbkmarkwrap_guest cbxwpbkmarkwrap_user_cat cbxwpbkmarkwrap-course \"><a  data-redirect-url=\"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course\/5978\/\"  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=\"5978\" 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=\"5978\" class=\"cbxwpbkmarkguestwrap\" id=\"cbxwpbkmarkguestwrap-5978\"><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\/5978\/\" \/>\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%2F5978%2F\">Register<\/a><\/p><\/div><\/div><\/div><p>Caracter\u00edsticas citol\u00f3gicas diagn\u00f3sticas Alta celularidad Patr\u00f3n predominantemente microfolicular o trabecular Api\u00f1amiento, superposici\u00f3n de c\u00e9lulas Alteraciones celulares (atipia leve, aumento uniforme de tama\u00f1o) Escaso coloide o ausencia de coloide Varias de estas caracter\u00edsticas deben estar presentes para diagnosticar una lesi\u00f3n folicular como \u201ccitol\u00f3gicamente sospechosa\u201d. Es poco com\u00fan encontrar marcada atipia celular, o mitosis. Los macr\u00f3fagos estan [&hellip;]<\/p>\n","protected":false},"featured_media":0,"parent":5969,"menu_order":1,"template":"","meta":[],"tags":[],"course_area":[115],"authors":[],"class_list":["post-5978","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 sospechosas - 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-sospechosas\/\" \/>\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 sospechosas - Eurocytology\" \/>\n<meta property=\"og:description\" content=\"Caracter\u00edsticas citol\u00f3gicas diagn\u00f3sticas Alta celularidad Patr\u00f3n predominantemente microfolicular o trabecular Api\u00f1amiento, superposici\u00f3n de c\u00e9lulas Alteraciones celulares (atipia leve, aumento uniforme de tama\u00f1o) Escaso coloide o ausencia de coloide Varias de estas caracter\u00edsticas deben estar presentes para diagnosticar una lesi\u00f3n folicular como \u201ccitol\u00f3gicamente sospechosa\u201d. Es poco com\u00fan encontrar marcada atipia celular, o mitosis. Los macr\u00f3fagos estan [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/\" \/>\n<meta property=\"og:site_name\" content=\"Eurocytology\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-26T09:24:29+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture1_7.jpg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Tiempo de lectura\" \/>\n\t<meta name=\"twitter:data1\" content=\"9 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/\",\"url\":\"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/\",\"name\":\"Lesiones foliculares citol\u00f3gicamente sospechosas - Eurocytology\",\"isPartOf\":{\"@id\":\"https:\/\/www.eurocytology.eu\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/#primaryimage\"},\"thumbnailUrl\":\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture1_7.jpg\",\"datePublished\":\"2023-03-17T08:42:44+00:00\",\"dateModified\":\"2023-04-26T09:24:29+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/#breadcrumb\"},\"inLanguage\":\"es\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"es\",\"@id\":\"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/#primaryimage\",\"url\":\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture1_7.jpg\",\"contentUrl\":\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture1_7.jpg\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.eurocytology.eu\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Courses\",\"item\":\"https:\/\/www.eurocytology.eu\/course\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Citolog\u00eda de tiroides\",\"item\":\"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Las lesiones foliculares\",\"item\":\"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/\"},{\"@type\":\"ListItem\",\"position\":5,\"name\":\"Lesiones foliculares citol\u00f3gicamente sospechosas\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.eurocytology.eu\/#website\",\"url\":\"https:\/\/www.eurocytology.eu\/\",\"name\":\"Eurocytology\",\"description\":\"The Eurocytology project is supported by the Leonardo da Vinci program with the aim of increasing access to training in clinical cytology and of harmonising training in this important specialty of pathology throughout the EU.\",\"publisher\":{\"@id\":\"https:\/\/www.eurocytology.eu\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.eurocytology.eu\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"es\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/www.eurocytology.eu\/#organization\",\"name\":\"Eurocytology\",\"url\":\"https:\/\/www.eurocytology.eu\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"es\",\"@id\":\"https:\/\/www.eurocytology.eu\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/www.eurocytology.eu\/wp-content\/uploads\/2023\/02\/logo_white.png\",\"contentUrl\":\"https:\/\/www.eurocytology.eu\/wp-content\/uploads\/2023\/02\/logo_white.png\",\"width\":250,\"height\":76,\"caption\":\"Eurocytology\"},\"image\":{\"@id\":\"https:\/\/www.eurocytology.eu\/#\/schema\/logo\/image\/\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Lesiones foliculares citol\u00f3gicamente sospechosas - Eurocytology","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/","og_locale":"es_ES","og_type":"article","og_title":"Lesiones foliculares citol\u00f3gicamente sospechosas - Eurocytology","og_description":"Caracter\u00edsticas citol\u00f3gicas diagn\u00f3sticas Alta celularidad Patr\u00f3n predominantemente microfolicular o trabecular Api\u00f1amiento, superposici\u00f3n de c\u00e9lulas Alteraciones celulares (atipia leve, aumento uniforme de tama\u00f1o) Escaso coloide o ausencia de coloide Varias de estas caracter\u00edsticas deben estar presentes para diagnosticar una lesi\u00f3n folicular como \u201ccitol\u00f3gicamente sospechosa\u201d. Es poco com\u00fan encontrar marcada atipia celular, o mitosis. Los macr\u00f3fagos estan [&hellip;]","og_url":"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/","og_site_name":"Eurocytology","article_modified_time":"2023-04-26T09:24:29+00:00","og_image":[{"url":"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture1_7.jpg"}],"twitter_card":"summary_large_image","twitter_misc":{"Tiempo de lectura":"9 minutos"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/","url":"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/","name":"Lesiones foliculares citol\u00f3gicamente sospechosas - Eurocytology","isPartOf":{"@id":"https:\/\/www.eurocytology.eu\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/#primaryimage"},"image":{"@id":"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/#primaryimage"},"thumbnailUrl":"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture1_7.jpg","datePublished":"2023-03-17T08:42:44+00:00","dateModified":"2023-04-26T09:24:29+00:00","breadcrumb":{"@id":"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/#breadcrumb"},"inLanguage":"es","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/"]}]},{"@type":"ImageObject","inLanguage":"es","@id":"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/#primaryimage","url":"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture1_7.jpg","contentUrl":"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/Picture1_7.jpg"},{"@type":"BreadcrumbList","@id":"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/lesiones-foliculares-citologicamente-sospechosas\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.eurocytology.eu\/"},{"@type":"ListItem","position":2,"name":"Courses","item":"https:\/\/www.eurocytology.eu\/course\/"},{"@type":"ListItem","position":3,"name":"Citolog\u00eda de tiroides","item":"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/"},{"@type":"ListItem","position":4,"name":"Las lesiones foliculares","item":"https:\/\/www.eurocytology.eu\/es\/course\/citologia-de-tiroides\/las-lesiones-foliculares\/"},{"@type":"ListItem","position":5,"name":"Lesiones foliculares citol\u00f3gicamente sospechosas"}]},{"@type":"WebSite","@id":"https:\/\/www.eurocytology.eu\/#website","url":"https:\/\/www.eurocytology.eu\/","name":"Eurocytology","description":"The Eurocytology project is supported by the Leonardo da Vinci program with the aim of increasing access to training in clinical cytology and of harmonising training in this important specialty of pathology throughout the EU.","publisher":{"@id":"https:\/\/www.eurocytology.eu\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.eurocytology.eu\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"es"},{"@type":"Organization","@id":"https:\/\/www.eurocytology.eu\/#organization","name":"Eurocytology","url":"https:\/\/www.eurocytology.eu\/","logo":{"@type":"ImageObject","inLanguage":"es","@id":"https:\/\/www.eurocytology.eu\/#\/schema\/logo\/image\/","url":"https:\/\/www.eurocytology.eu\/wp-content\/uploads\/2023\/02\/logo_white.png","contentUrl":"https:\/\/www.eurocytology.eu\/wp-content\/uploads\/2023\/02\/logo_white.png","width":250,"height":76,"caption":"Eurocytology"},"image":{"@id":"https:\/\/www.eurocytology.eu\/#\/schema\/logo\/image\/"}}]}},"_links":{"self":[{"href":"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course\/5978","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course"}],"about":[{"href":"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/types\/course"}],"version-history":[{"count":1,"href":"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course\/5978\/revisions"}],"predecessor-version":[{"id":6933,"href":"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course\/5978\/revisions\/6933"}],"up":[{"embeddable":true,"href":"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course\/5969"}],"wp:attachment":[{"href":"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/media?parent=5978"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/tags?post=5978"},{"taxonomy":"course_area","embeddable":true,"href":"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course_area?post=5978"},{"taxonomy":"authors","embeddable":true,"href":"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/authors?post=5978"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}