甲状腺显示胸腺样分化的癌2例临床病理观察  

Carcinoma showing thymus-like differentiation of thyroid:report of two cases

作　　者：李亮[1] 韩翠红[1] 周凤娟[1] 王传国[1] 林凡忠[1] 

机构地区：[1]济宁市第一人民医院病理科,山东济宁272011

出　　处：《诊断病理学杂志》2016年第5期346-348,共3页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨显示胸腺样分化的癌(CASTLE)的临床病理学特征、诊断与鉴别诊断、治疗与预后。方法分析2例显示胸腺样分化的癌的临床表现、组织形态学及免疫组化特征,并进行观察及文献复习。结果临床主要表现为颈部肿块,肿物活动度差、质硬,与周围组织界限不清。镜下肿瘤细胞成片状、巢状、岛状排列,肿瘤细胞间常伴有淋巴细胞浸润,颇像原发于甲状腺的鳞状细胞癌。免疫组化:肿瘤细胞CK、CD5、CD117和bcl-2均(+)。结论CASTLE是一种低度恶性肿瘤,非常少见,常常被误诊为发生于甲状腺的鳞状细胞癌,故将两者鉴别开来十分必要。Objective To study the clinicopathological features,diagnosis and differential diagnosis,treatment and prognosis of carcinoma showing thymus-like differentiation（ CASTLE）. Methods Two cases of CASTLE were studied on the clinical manifestations,HE morphology and immunohistochemical characteristics. Related articles were reviewed.Results The major clinical presentation included a neck lump,poor movement and qualitative hardness,with the unclear surrounding tissue boundaries. Microscopically,tumor cells arranged in sheet,nests,island patterns,often accompanied by lymphocytic infiltration between tumor cells, like primary squamous cell carcinoma of the thyroid.Immunohistochemically,tumor cells shown the same immunephenotype： CK ＋,CD5 ＋,CD117 ＋ and Bcl-2＋.Conclusion CASTLE is a low-grade malignant tumor; it is rare and often misdiagnosed as squamous cell carcinoma of the thyroid,causing excessive treatment; therefore,the differential diagnosis between both is very necessary.

关 键 词：甲状腺 显示胸腺样分化的癌 临床病理 

分 类 号：R738.6[医药卫生—肿瘤]