嗜酸细胞型甲状腺髓样癌3例并文献复习  

Oncocytic variant of medullary thyroid carcinoma:3 cases report with review of literatures

作　　者：刘栋[1] 罗丕福 尹自长 吴涛[1] 侯晓涛 李晶[1] 周辉蓉[1] 梁小曼[2] 

机构地区：[1]广州金域医学检验中心病理科,广州510330 [2]中山大学附属肿瘤医院病理科,广州510060

出　　处：《临床与实验病理学杂志》2017年第10期1097-1100,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨嗜酸细胞型甲状腺髓样癌(medullary thoyrid carcinoma,MTC)的临床病理学特征及鉴别诊断。方法回顾性分析3例嗜酸细胞型MTC的组织学形态、免疫表型及其中2例的电镜形态,并复习相关文献。结果肿瘤细胞胞质丰富、嗜酸,胞质颗粒状,细胞边界清楚,核增大,呈圆形或卵圆形,部分细胞见明显核仁;呈实性片状、梁状或滤泡状排列,浸润性生长。免疫表型:3例TG均阴性;2例Calcitonin阳性,1例阴性。电镜观察例2、例3见大量线粒体及多少不等的神经内分泌颗粒。结论嗜酸细胞型MTC非常罕见,形态多样,在甲状腺嗜酸细胞病变诊断时,嗜酸细胞型MTC应纳入鉴别诊断中,结合其免疫表型、临床血清学及电镜检查可确诊。Purpose To investigate the clinicopathologic features and differential diagnosis of oneoeytie variant of medullary thyroid carcinoma （MTC）. Methods Morphological, immunohistochemical findings on 3 oncocytic variant of MTC cases and electron microscopic findings on 2 of these 3 cases were studied, with review of the relevant literatures. Results The cytoplasm was abundant, eosinophilic and granular with defined margins. The nuclei were enlarged, round to oval. Prominent nucleoli were identified in some cells. Tumor cells formed sheets, trabeculae or follicles with infiltrative pattern. Immunohistoehemieally, thyroglobulin （TG） was negative in all 3 cases. Calcitonin was positive in 2 cases and negative in 1 case. Ultrastructurally, a large number of mitochondria and various neuroendocrine granules were found in the 2nd and 3rd cases. Conclusion Oncocytic variant of MTC is very rare with variable histopathologic appearances, It should be considered in diagnosing oncocytic lesions of thyroid. A definite diagnosis can be rendered based on comprehensive findings of the immunohistochemistry, serology study and electron microscopy. It needs to avoid misdiagnosis and missed diagnosis.

关 键 词：甲状腺肿瘤 髓样癌 嗜酸细胞型 

分 类 号：R736.1[医药卫生—肿瘤]