卵巢甲状腺肿伴乳头状癌临床病理分析并文献复习  

Clinicopathologic characteristics of papillary thyroid carcinoma in struma ovarii and review of the literature

作　　者：彭全洲[1] 王晓玫[1] 左敏[1] 胡锦涛[1] 朱富强[1] 成志强[1] 

机构地区：[1]暨南大学第二临床医学院深圳市人民医院病理科,广东省518020

出　　处：《中华临床医师杂志（电子版）》2015年第13期52-55,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：深圳市科技计划项目资助(201302034)

摘　　要：目的探讨卵巢恶性甲状腺肿的临床病理特征、诊断和鉴别诊断、分子遗传学进展及预后。方法对2013年5月收集的1例卵巢甲状腺肿伴甲状腺乳头状癌的临床表现、大体及组织学形态、免疫组化等进行观察研究,并进行文献复习。结果患者为51岁女性,体检发现盆腔包块3个月入院。右附件囊肿,最大直径10.0 cm,切面囊实性伴陈旧性出血。镜下肿瘤主要由成熟的甲状腺滤泡组成,部分呈乳头状结构,毛玻璃样核,可见核沟及核内包涵体,组织学类型符合甲状腺乳头状癌。免疫组化肿瘤细胞甲状腺球蛋白(-),TTF-1、CK19、HBME-1、galectin-3均(+),而甲状腺成分甲状腺球蛋白和TTF-1(+),CK19、HMBE-1和galectin-3均(-)。结论卵巢甲状腺肿伴甲状腺乳头状癌是恶性甲状腺肿的主要类型,恶性变的诊断标准同甲状腺癌,免疫组化有助于诊断。因其少见,治疗方法尚未统一,可参照卵巢生殖细胞肿瘤的治疗方案,预后良好。Objective To explore the clinicopathologic characteristics, immunophenotype, diagnosis and differential diagnosis, genetic feature of malignant struma ovarii.MethodsA case of papillary thyroid carcinoma in struma ovarii was studied with clinical manifestations, histology and immunohistochemical staining, and its clinical and pathological findings were further analyzed with review of the literatures.Results A 51-year-old female was admitted with abdominal distension and intra-abdominal mass was found for 3 months. There was a right ovarian mass measuring 10 cm＆#215;9 cm＆#215;6 cm. The external surface of the cyst was mainly smooth with a small area of yellow/red discolouration. Histology of the ovarian tumour showed thyroid tissue characteristic of struma ovarii. Tumor cells of the papillary carcinoma were diffusely positive for CK19, HMBE-1, TTF-1, and galectin-3, was negative for Thyroglobulin. The thyroid tissue were positive for Thyroglobulin and TTF-1, were negative for CK19, HMBE-1 and galectin-3.ConclusionsThe criteria for malignancy is similar to that seen in thyroid, such as ground glass overlapping nuclei, nuclear grooves, and papillary architecture for papillary thyroid carcinoma in struma ovarii. Because of its rarity, the diagnosis and management of the tumour have not been clearly defined.

关 键 词：卵巢甲状腺肿 诊断 预后 恶性 乳头状癌 

分 类 号：R737.31[医药卫生—肿瘤]