甲状腺原发性平滑肌肉瘤临床病理观察

目的：探讨甲状腺原发性平滑肌肉瘤的临床病理特征、诊断与鉴别诊断。方法对1例原发于甲状腺的平滑肌肉瘤进行病理特征及免疫组织化学分析，并复习相关文献。结果肉眼：肿物5．5cm×4．0cm×3．5cm，切面灰黄色，质中，局部质硬。镜检：肿瘤由梭形细胞组成，束状排列，胞质嗜伊红，核卵圆形，异型明显，核分裂象易见。瘤组织中可见散在大小不一的滤泡并向周围组织侵袭。免疫组织化学示瘤细胞Vimentin、SM A、Caldesmon和Actin表达阳性，CK、CK8、EM A、T T F‐1、P53和LCA表达阴性。结论甲状腺原发性平滑肌肉瘤非常罕见，其诊断需结合临床、影像学资料、组织学及免疫组织化学。

Clinicopathological observation on primary leiomyosarcoma of thyroid gland

Objective To investigate the clinicopathological features ,diagnosis and differential diagnosis of primary leiomyo‐sarcoma of the thyroid gland .Methods The pathological characteristics and immunohistochemical features in a case of primary leio‐myosarcoma of the thyroid gland were analyzed and the relevant literatures were reviewed .Results Grossly ,the mass measured 5 .5 cm × 4 .0 cm × 3 .5 cm ,gray and yellow in cut surface and partial hard quality .Histologically ,the tumor was composed of spin‐dle cells ,arranging in bundles with obvious dysplasia ,nuclear mitosis was easily found .The tumor infiltrated thyroid follicles and in‐vaded surrounding tissues .The immunohistochemical study showed that Vimentin ,SMA ,Caldesmon and Actin were positive ,and CK ,CK8 ,EMA ,TTF‐1 ,P53 and LCA were negative .Conclusion Primary leiomyosarcoma of thyroid gland is extremely rare ,its diagnosis should be combined with clinical and imageologic data ,histological characteristics and immunohistochemistry .