4例甲状腺内胸腺癌的临床病理学特征  

Clinicopathological characteristics of intrathyroid thymic carcinoma:Four case report

作　　者：谢闵 袁娜 孙燃 许增祥[2] XIE Min;YUAN Na;SUN Ran;XU Zengxiang(Department of Pathology,East China Normal University(Wuhu No.2 People’s Hospital),Wuhu Anhui 241001;Department of Pathology,Wannan Medical College,Wuhu Anhui 241001,China)

机构地区：[1]华东师范大学附属芜湖医院(芜湖市第二人民医院)病理科,安徽芜湖241001 [2]皖南医学院病理解剖学教研室,安徽芜湖241001

出　　处：《临床与病理杂志》2022年第11期2850-2856,共7页Journal of Clinical and Pathological Research

基　　金：芜湖市应用基础及创新环境研究项目(2021jc2-2);芜湖市卫生高层次人才分层培养计划-卫生骨干人才。

摘　　要：通过回顾性分析4例甲状腺内胸腺癌(intrathyroid thymic carcinoma,ITTC)患者的临床病理学资料及免疫表型特征、EB病毒感染及随访情况,探讨ITTC的临床病理学特征、相关分子机制研究情况、诊断、治疗和预后,以提高对该疾病的认识。4例患者均为女性,年龄为36~63岁,肿瘤最大直径为0.7~3.0 cm。镜下肿瘤具有推挤式边缘,细胞排列呈条索状、巢团状或岛屿状,并可见胸腺肿瘤分叶状结构或胸腺小体样结构。免疫组织化学染色示肿瘤细胞CD5、CD117、CK/pan、CK5/6、p63、p40阳性,Ki-67增殖指数为10%~30%。原位杂交检测EBER结果均为阴性。其中1例合并甲状腺乳头状癌(papillary thyroid carcinoma,PTC),4例均行甲状腺腺叶切除及局部淋巴结清扫术,术后随访10~34个月,均未复发或转移。ITTC为罕见的甲状腺肿瘤,预后尚好,术中冰冻及细针穿刺中诊断难度较大,特别是合并甲状腺其他肿瘤时,易误诊。结合形态学特征及免疫组织化学有助于诊断及鉴别诊断。To investigate the clinicopathological characteristics of intrathyroid thymic carcinoma(ITTC),related to molecular mechanisms,treatment and prognosis,4 cases of ITTC were retrospectively reviewed.The clinicopathological data,immunophenotypic characteristics,Epstein-Barr virus infection and related literatures were analyzed to improve understanding of the disease.All 4 patients were female,aged 36 to 63 years.The maximum diameters of the tumor were between 0.7 and 3.0 cm.Histologically,the tumor cells were arranged in cords,nests,or islands and lobulated with a pushing edge.Thymus corpuscular structures were observed in some areas.Immunohistochemical staining showed positive expressions of CD5,CD117,CK/pan,CK5/6,p63,p40,and Ki-67 proliferation index was 10%to 30%.The EBER test results of in situ hybridization were negative.One case was complicated with papillary thyroid carcinoma(PTC),all cases underwent thyroidectomy and local lymph node dissection.After 10 to 34 months of postoperative follow-up,all cases had no recurrence or metastasis.ITTC is a rare thyroid tumor with good prognosis.It is difficult to diagnose with intraoperative freezing and fine needle puncture,especially combined with other thyroid tumors.Combined with immunohistochemistry,it is helpful for diagnosis and differential diagnosis.

关 键 词：甲状腺内胸腺癌 临床病理学 免疫表型 原位杂交EBER 

分 类 号：R736.1[医药卫生—肿瘤]