甲状腺胸腺样分化癌临床病理观察

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例甲状腺GASTLE进行临床病理和免疫组化分析,并结合文献讨论其诊断与鉴别诊断。结果甲状腺CASTLE为灰白色实性分叶状肿块;镜下肿瘤由纤维组织条索状分割或呈不同大小的巢块,纤维间隔中有淋巴细胞及浆细胞浸润;肿瘤细胞呈多边形,胞界不清,泡状核,核仁突出,可发生鳞状细胞分化;免疫组化肿瘤细胞表达CD5及CD117。结论甲状腺CASTLE是一种少见的甲状腺恶性肿瘤,发生于中老年人,组织学上与胸腺癌类似,应与甲状腺未分化癌、鳞状细胞癌、转移性淋巴上皮瘤样癌等鉴别,免疫组化示CD5和CD117( )有助于诊断。

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

Objective To investigate the clinical-pathological features of carcinoma showing thymus-like differentiation(CASTLE) of the thyroid. Methods This rare case of CASTLE was studied for histomorphology and immunohistochemical features with review of the related literature. Results Macroscopically,the tumor showed a solid gray-white mass and was separated into lobules by fibrous tissues,mature lymphocytes and plasma cells infiltration in the fibrous septum.The tumor cells were polygonal to spindle in shape,vesicular nucleus,distinct nucleoli and scattered squamous pattern of differentiation.The tumor stained positively for CD5 and CD117. Conclusion Carcinoma showing thymus-like differentiation is a rare malignancy that occurs in the soft tissues of the neck or in the thyroid gland.It needs to be distinguished from undifferentiated thyroid carcinoma,squamous cell thyroid carcinoma,lymphoepithelioma-like carcinoma.Immunohistochemical staining for CD5 and CD117 is helpful in confirming the diagnosis.