甲状腺胸腺样分化癌临床病理分析

目的 探讨甲状腺胸腺样分化癌(CASTLE)的临床病理特征.方法 对1例CASTLE进行临床、病理及免疫组织化学观察,并结合文献讨论.结果 患者,男性,38岁,临床表现为甲状腺无痛性包块,超声检查显示低回声.镜下瘤细胞由增生的纤维间质分割成巢状或岛状.这种结构与胸腺癌中的分叶状结构非常相似.瘤细胞呈鳞状细胞或合体样细胞分化,淡嗜酸性胞浆,核椭圆空泡状,并有明显核仁,免疫组织化学瘤细胞CK、CD5、CD117阳性,TG、Caleitonin、SYN、NSE、TTF-I、EBV阴性.结论 CASTLE是类似于胸腺上皮样结构的甲状腺癌,是很少见的甲状腺肿瘤,免疫组织化学标记与胸腺癌相同.

Carcinoma showing thymus-like element of the thyroid:a clinicopathological analysis

Objective To investigate the clinical-pathological feature of careinoma showing thymus-like dif- ferentiation(CASTLE) of the thyroid. Methods The clinical data, histopathologie changes and immunohistoche- mical findings were studied in 1 case of carcinoma showing thymus-like differentiation of the thyroid with review of the related literature. Results The age of the patient was 38 years old. The clinical manifestation displayed a pain- less mass in the thyroid. On ultrasound the tumor appeared hypoechoic. Histologically the tumor cells were arranged in nests and islands accompanied by desmoplasfie strorna. The architecture thus showed a superficial resemblance to the lobulation seen in thymic carcinomas. The tumor was characterized by squamoid or syheytial-appearing cells with lightly eosinophilic cytoplasm. Nuciec were oval, pale to versicular, and had small distinct nudeoli. Immunohistoche- mically the tumor cells were positive for CK, CD5, CD117 but neyative for TG, Calcitonin, SYN, NSE, TTF- 1, EBV. Conclusion CASTLE is a very rate a carcinoma thyroid with architectural resemblance to thymic epithelial tumors. The immunophenolype of CASTLE is identical with that of thymie carcinoma.