Warthin瘤样变异型甲状腺乳头状癌临床病理观察  

Warthin-like variant of papillary thyroid carcinomas:clinicopathological analyses

作　　者：庞雅青 潘艺 汪露祥 方威 PANG Ya-qing;PAN Yi;WANG Lu-xiang;FANG Wei(Department of Pathology,Huangshan People’s Hospital,Huangshan 245000,China)

机构地区：[1]安徽省黄山市人民医院病理科,安徽黄山245000

出　　处：《诊断病理学杂志》2022年第4期305-308,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的 探讨Warthin瘤样变异型甲状腺乳头状癌(Warthin-like variant papillary thyroid carcinomas, WLV-PTC)的临床病理特征、免疫表型、诊断及鉴别诊断要点。方法 分析2例WLV-PTC的临床资料、组织学特征及免疫表型,并结合相关文献探讨其临床病理特征。结果 男、女各1例,年龄分别为55岁和54岁,均为无意中发现颈部包块,遂前来就诊。肿瘤切面灰白色或灰褐色、质硬,界尚清。WLV-PTC与涎腺的Warthin瘤具有相似的形态学特征,肿瘤细胞排列成乳头状,其表面被覆单层或复层上皮,胞质丰富嗜酸性,乳头中心见大量淋巴细胞。2例均伴有淋巴细胞性甲状腺炎。免疫组化显示上皮细胞CK19、Galectin-3、TTF-1(+),CD56(-),间质淋巴细胞CD3、CD20(+)。结论 WLV-PTC是一种罕见的甲状腺乳头状癌亚型,具有独特的组织形态,大部分合并淋巴细胞性甲状腺炎,预后良好。Objective To investigate the clinicopathological features, immunophenotype, diagnosis and differential diagnosis of Warthin-like variant of papillary thyroid carcinomas(WLV-PTC). Methods The clinicopathlogical data, pathological and immunohistochemical fertures of 2 cases of WLV-PTC were analyzed and the clinicopathological features were discussed in combination with review of relevant literature. Results One male and one female, aged 55 and 54 years respectively, were found with a neck mass by accident. The section of tumor was grayish white or grayish brown, hard in texture and clear boundary. WLV-PTC was similar to the parotid Warthin tumor in morphological features. Microscopically, the tumor cells were arranged in papillae, the surface of which was covered with single or laminated eosinophilic epithelia, while the cores of the papillae infiltrated with lymphoid cells. 2 cases were associated with lymphocytic thyroiditis. Immunohistochemistry showed positive for CK19, Galectin-3 and TTF-1, but negative for CD56 in epithelial cells, while CD3, CD20 positive in lymphocytes. Conclusion WLV-PTC is a rare subtype of papillary thyroid carcinoma with unique histological morphology, most of whicn are associated with lymphocytic thyroiditis, and the prognosis is good.

关 键 词：Warthin瘤样变异型甲状腺乳头状癌 淋巴细胞性甲状腺炎 鉴别诊断 临床病理 

分 类 号：R736.1[医药卫生—肿瘤]