口腔软组织转移性甲状腺肉瘤样癌1例和文献复习  

Oral soft tissue metastasis from sarcomatoid thyroid carcinoma: 1 case report and a review of literatures

作　　者：张缨[1] 李祥周[1] 周瑜[1] 曹晓卉[1] 黄勇[1] 

机构地区：[1]解放军八一医院病理科,南京210002

出　　处：《临床肿瘤学杂志》2012年第8期740-743,共4页Chinese Clinical Oncology

摘　　要：目的探讨甲状腺肉瘤样癌(STC)的临床病理学特征、诊断和鉴别诊断。方法观察1例甲状腺癌术后原发部位无明显病灶仅有口腔软组织转移的STC的临床特征、细胞和组织学形态以及免疫表型,并复习文献。结果患者女性,63岁,右上腭处带蒂息肉状肿物。光镜下肿瘤组织呈广泛侵袭性,由梭形细胞、多形性巨细胞和上皮样细胞混合构成,核怪异,单个或多个,核仁明显,病理性核分裂象多见,伴有凝固性坏死及多形核白细胞浸润。免疫表型:TTF-1(+)、Vimentin(+++)、CKpan(+)、CK7个别细胞(+)、Ki-67大约35%(+)、SMA(+)、Tg(-)、CD68(-)、LCA(-)、Myogenin(-)、MG(-)、HMB45(-)、S-100(-)。结论口腔软组织转移性STC非常少见,其恶性程度高,预后差,必须结合临床病史、组织学形态及免疫表型进行诊断,且需与其他肿瘤鉴别诊断。Objective To explore the clinicopathological characteristics and differential diagnosis of sarcomatoid thyroid carcinoma（STC）.Methods One case of oral soft tissue metastasis from STC without thyroid focus was reported and the relevant literatures were reviewed.Results The patient was a 63 years old woman.A polypoid mass with peduncle was located in the right upper jaw.Histopathologically,STC was a widely invasive tumour composed of an admixture of spindle cells,pleomorphic giant cells and epithelioid cells.The nuclei were bizarre and single or multiple.They revealed prominent nucleoli.Mitotic figures could be numerous.Extensive coagulative necrosis with accompanying polymorphonuclear leukocytes was often seen.Immunohistochemically,tumour cells expressed TTF-1,Vimentin,CKpan,SMA and Ki-67.CK7 was only positive in a few tumour cells.Tg,CD68,LCA,Myogenin,MG,HMB45 and S-100 were negative.Conclusion Oral soft tissue metastasis of STC is rare.It is a highly malignant tumour with poor prognosis.The diagnosis of STC should be based on clinical history,histopathological changes and immunohistochemical tests.It should be distinguished from other tumours.

关 键 词：口腔软组织转移性肿瘤 甲状腺肿瘤/肉瘤样癌 免疫组织化学 鉴别诊断 

分 类 号：R739.91[医药卫生—肿瘤]