肾上腺内异位甲状腺临床病理观察  

Ectopic thyroid tissue in the adrenal gland: a clinicopathologic study combined with literature review

作　　者：高敏[1] 张世豪[1] 廖玉婷[1] 温永琴[1] 何建芳[1] 赵东晖[1] 梁远秋 GAO Min ZHANG Shi-hao LIAO Yu-ting WEN Yong-qin HE Jian-fang ZHAO Dong-hui LIANG Yunn-qiu(Dongguan People＇ s Hospital of Southern Medical University, Dongguan 523059, Chin)

机构地区：[1]南方医科大学附属东莞市人民医院病理科,广东东莞523059

出　　处：《诊断病理学杂志》2017年第3期198-201,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨肾上腺内异位甲状腺的临床病理特征及可能的发病机制。方法对1例肾上腺内异位甲状腺进行组织形态学观察、免疫组化及分子检测,并复习相关文献。结果患者女性,31岁。体检发现左侧肾上腺占位。肿物呈囊实性,囊腔内充满嗜伊红的胶质样物,伴有少量泡沫细胞反应,囊壁可见肾上腺组织及甲状腺组织混杂存在;甲状腺滤泡由单层上皮细胞构成,细胞核无异型,未见核沟及核内包涵体。免疫组化:滤泡上皮CK、TPO、Tg和TTF-1(+),CK19、galectin-3、CT、Syn和CgA(-)。PCR检测显示,BRAF V600E及KRAS基因未见突变。结论异位甲状腺是一种先天性发育异常,发生在肾上腺极为罕见,肾上腺内异位甲状腺的确切发病机制尚不清楚,有待进一步研究。Objective To investigate the clinicopathological characteristics,and the possible occurrence mechanism of ectopic thyroid in the adrenal gland. Methods We report a case of of ectopic thyroid in the adrenal gland in a 31-yearold woman. Pathologic analyses including histomorphologic,immunohistochemical and molecular studies were performed to evaluate the clinicopathological features of ectopic thyroid in the adrenal gland and review of the literature. Results The surgical specimen showed a cyst-solid mass in the adrenal gland. The cystic cavity was filled with eosinophilic,colloid-like substance with a small amount of reactive foam cells. The cyst wall included many follicles that was surrounded by a monolayer of follicular cells,occupied by colloid,intermingled with adrenal tissue. There were no nuclear atypia,grooves or cytoplasmic pseudo-inclusions. Follicular cells were immunohistochemically positive for CK,TPO,Tg,TTF-1 and negative for CK19,galectin-3,CT,Syn and CgA. Furthermore,molecular analysis about BRAF V600 E 及 KRAS genes did not identify mutations. Conclusion Ectopic thyroid is a congenital developmental defect,ectopic thyroid in the adrenal gland is extremely rare,the mechanism is unknown and warrants further study.

关 键 词：异位甲状腺 肾上腺 发病机制 

分 类 号：R736.6[医药卫生—肿瘤]