摘要
目的:探讨甲状腺内胸腺癌(intrathyroid thymic carcinoma,ITTC)的临床病理学特征,提升病理医师对本病的认识。方法:回顾性分析2例ITTC的临床影像表现、病理形态、免疫表型、治疗及预后,并检索、复习相关国内外文献。结果:2例肿瘤组织镜下呈分叶状,间质见纤维组织分隔,瘤巢周见成熟淋巴细胞浸润,与胸腺癌类似,瘤细胞免疫组化表达CD5、CD117、CK5/6、p63、单克隆抗体PAX-8,不表达TG、TTF-1,原位杂交EBER阴性,BRAF V600E无突变,病例2还见到典型乳头状癌,免疫表达甲状腺乳头状癌标记。2例患者均行甲状腺叶切除及淋巴结清扫,术后放化疗1个月,分别于1年后、2年后随访,无复发和转移。结论:ITTC是原发于甲状腺内罕见具有胸腺样分化的低度恶性肿瘤,预后好,少见复发和转移,需与形态相近的高度恶性甲状腺肿瘤鉴别,避免过度治疗,此外,ITTC表达单克隆抗体PAX-8,同时见乳头状癌成分,文献中鲜有报道。
Objective:To investigate the clinicopathological features of intrathyroid thymic carcinoma(ITTC) and improve the understanding of clinicopathologists.Methods:Clinical imaging findings,histopathologic morphology,immunophenotype,treatment and prognosis of 2 cases of ITTC were retrospectively analyzed,and the relevant literature was searched and reviewed.Results:The tumors were lobed,separated by fibrous tissue.Mature lymphocytes were infiltrated around the nests.CD5,CD117,CK5/6,p63 and monoclonal antibody PAX-8 were expressed by immunohistochemistry,but TG and TTF-1 were not expressed,EBER was negative in situ hybridization,and BRAF V600E was not mutated.Case 2 also showed typical papillary carcinoma with immune expression of thyroid papillary carcinoma markers.Thyroidectomy and lymph node dissection were performed in all patients.Postoperative radiotherapy and chemotherapy for one month,no recurrence or metastasis was observed after one and two years of follow-up.Conclusion:ITTC is a rare,low-grade malignant tumor that originates in the thyroid and has thymus-like differentiation.It has a good prognosis with rare recurrence and metastasis.It needs to be distinguished from highly malignant thyroid tumors with similar morphology to avoid overtreatment.Moreover,ITTC expresses the monoclonal PAX-8 and simultaneously shows papillary carcinoma components,which is rarely reported in the literature.
作者
苑红梅
朱伦
姚娟
艾志龙
YUAN Hongmei;ZHU Lun;YAO Juan;AI Zhilong(Department of Pathology,Huai'an Hospital Affiliated to Yangzhou University(the Fifth People's Hospital of Huai'an),Jiangsu Huai'an 223300,China;Department of Pathology,the Affiliated Huai'an Hospital of Xuzhou Medical University(the Second People's Hospital of Huai'an),Jiangsu Huai'an 223002,China;Department of Thyroid and Breast Surgery,Zhongshan Hospital,Hehai University,Shanghai 200032,China)
出处
《现代肿瘤医学》
2025年第3期403-408,共6页
Journal of Modern Oncology
基金
2023年上海市创新医疗器械应用示范项目(编号:23SHS05200)。
关键词
甲状腺
胸腺癌
临床病理学特征
thyroid
thymus cancer
clinical pathological characteristics
