卵巢甲状腺类癌临床病理探讨

目的 探讨卵巢甲状腺类癌的临床病理特征、诊断及鉴别诊断.方法 对2例发生在卵巢甲状腺类癌病例应用免疫组化Syn,CgA,S-100,CT,Vimtime,Tg,CK,NSE,P63,Ki67,CEA,α-inhibin进行检测,并结合相关文献进行讨论.结果 2例患者均为绝经后女性,例1患者以盆腔包块为主要表现,伴有便秘,血CA199升高,例2患者因手术切除其他肿瘤及附件,送病理活检发现.2例患者巨检肿瘤均为单纯型.镜检肿瘤均由甲状腺组织及类癌组织构成,类癌为梁状与岛状混合型.免疫组化:2例患者类癌细胞Syn(2/2+),CgA(2/2+),NSE(1/2+),Ki67(3％+,5％+),CK(1/2+),S-100(2/2-),CEA(2/2-),P63(2/2-),CT(2/2-),Vimtime(2/2-),Tg(2/2-),α-inhibin(2/2-);甲状腺滤泡Tg(2/2+),CK(2/2+),Vimtime(1/2+),Syn(2/2-),CgA (2/2-),NSE(2/2-),Ki67(2/2-),S-100(2/2-),CEA(2/2-),P63(2/2-),CT(2/2-),α-inhibin(2/2-).2例患者均为Ⅰ期,例1患者术后行化疗,例2术后未做任何治疗,分别随访57个月及2个月,均未见复发及转移.结论 卵巢甲状腺类癌是一种非常罕见的具有独特临床病理学特征的高度特殊性生殖细胞肿瘤,伴有甲状腺组织分化,一般预后良好,要与小圆形细胞肿瘤鉴别,结合免疫组化,可与之鉴别.

Clinicopathological study of ovarian carcinoid tumor of thyroid

Objective Ovarian carcinoid tumor of the thyroid clinical and pathological features, diagnosis and differential diagnosis. Methos Two cases of thyroid gland in ovarian carcinoid cases with immunohistochemical Syn, CgA, S-100, CT, Vimtime, Tg, CK, NSE, P63, Ki67, CEA, α-inhibin were detected, and discussed with relevant literature.Results Two patients were postmenopausal women, example 1 in patients with pelvic mass as the main performance, accompanied by constipation, elevated blood CA199, example 2 patients due to surgical removal of tumors and other accessories, sent to biopsy findings. Two patients with giant tumors are of simple inspection. Microscopic examination of thyroid tissue and carcinoid tumor by tissue composition, trabecular carcinoid is mixed with the island. Immunohistochemistry. Class 2 patients cancer Syn （2 / 2 ＋）, CgA （2 / 2 ＋）, NSE （1 / 2 ＋）, Ki67 （3% ＋, 5% ＋）, CK （1 / 2 ＋）, S-100 （2/2-）, CEA （2/2-）, P63 （2/2-）, CT （2/2-）, Vimtime （2/2-）, Tg （2/2-）, α-inhibin （2/2-）~ Thyroid follicular Tg （2 / 2 ＋）, CK （2 / 2 ＋）, Vimtime （1 / 2 ＋）, Syn （2/2-）, CgA （2/ 2-）, NSE （2/2-）, Ki67 （2/2-）, S-100 （2/2-）, CEA （2/2-）, P63 （2/2-）, CT （2/2-）, c~ -inhibin （2/2-）. Two patients were stage I , example 1 postoperative chemotherapy, example 2 without making any treatment after surgery, were followed up for 57 months and 2 months, showed no recurrence and metastasis. Conclusion Ovarian carcinoid tumor of thyroid is a very rare clinical and pathological features of the unique specificity of a high degree of germ cell tumors, associated with thyroid tissue differentiation, generally good prognosis, with the identification of small round cell tumor, combined with immunohistochemistry, can identify with them.