甲状腺透明变梁状肿瘤6例临床病理分析  

Clinical-pathological analysis of 6 cases with hyalinizing trabecular tumor of the thyroid

作　　者：刘媛媛[1] 张伟[1] 齐殿军[2] 李娟[1] 张学义[1] 

机构地区：[1]抚顺矿务局总医院(中国医科大学第七临床医院)病理科,辽宁抚顺113008 [2]中国医科大学附属第一医院全科医学科,辽宁沈阳110001

出　　处：《现代肿瘤医学》2015年第18期2583-2587,共5页Journal of Modern Oncology

摘　　要：目的：探讨甲状腺透明变梁状肿瘤（hyalinizing trabecular tumor,HTT）临床病理特点、诊断及其鉴别诊断。方法：对6例HTT组织进行组织形态学观察及免疫组化标记,总结其临床资料和组织病理特征,选用抗体包括Tg、TTF-1、CK19、Galectin-3、Cg A、Ki67等。结果：本组6例患者5女1男,发病平均年龄44岁,肿瘤直径1.5~4.0cm（平均3.0cm）;镜下瘤组织呈梁状,界限清楚,可见薄的纤维膜包绕;瘤细胞呈椭圆形、梭形或多角形,胞浆嗜酸性,细颗粒状,伴有透明变性基质;细胞核可见核沟及假包涵体,核分裂象偶见。免疫组化显示瘤细胞表达Tg、TTF-1、Galectin-3、Ki67等,其中Ki67表达定位于细胞膜。结论：甲状腺HTT具有较独特的病理组织学改变和免疫表型,诊断依靠形态学特征,免疫组化标记有助于与甲状腺滤泡性腺瘤、甲状腺乳头状癌、甲状腺髓样癌等相鉴别。Objective：To explore the clinical -pathological characteristics,diagnosis,and differential diagnosis of hyalinizing trabecular tumor（HTT）of the thyroid.Methods：We summarized the clinical data and histopathological features of 6 HTT samples by histomorphological observation and immunohistochemistry analysis.The adopted anti-bodies were Tg,TTF -1,CK19,Galectin -3,CgA,Ki67 etc.Results：Five female and 1 male patients were recriuted in the current study,with an average onset age of 44 years.The diameter of the tumors was 1.5 ~4.0cm （average 3.0cm）.The tumor tissues exhibited trabecular pattern,and their boundaries were clear,which were wrapped with fi-brous membranes.The tumor cells were oval,spindle or polygonal,with eosinophilic and granular cytoplasms,and were accompamied with hyaline degeneration of the matrix.Nuclear groove and intranuclear pseudo -inclusions could be checked.The mitotic figures were rarely observed.Immunohistochemistry showed that some markers,such as Tg,TTF-1,Galectin -3,Ki67,were expressed in tumor cells,and the expression of Ki67 was localized in cell membrane. Conclusion：Thyroid HTT exhibits unique pathohistological and immune phenotypes,and the diagnosis relies on mor-phological features.Immunohistochemical staining is helpful in differential diagnosis of thyroid follicular adenoma,pa-pillary thyroid carcinoma,and medullary thyroid cancer,and others.

关 键 词：透明变梁状肿瘤 滤泡性腺瘤 免疫组化 

分 类 号：R736.1[医药卫生—肿瘤]