甲状腺岛状癌1例报道并文献复习

Insular carcinoma of thyroid:a case report and review of literature

目的 介绍并讨论甲状腺岛状癌的临床病理特征。方法 分析 1例有 8年甲状腺滤泡性腺瘤病史癌变的岛状癌 ,结合免疫组化进行文献复习。结果 岛状癌的肿瘤组织由大小一致的低分化小细胞组成 ,瘤细胞或细胞核呈轻度不典型性 ,不易找到核仁和有丝核分裂象 ,排列成巢状 ,呈小岛状结构 ,局灶可见大片明显的坏死 ,存活的肿瘤细胞围绕小血管排列成放射状 ,形成“血管外皮瘤样”结构。肿瘤细胞还可呈密集实体状、微滤泡状排列。岛状癌的复发率和 10年生存率介于高分化的乳头状癌、滤泡性癌和未分化的间变性癌之间。结论 岛状癌为甲状腺癌中的一种独立类型。

Objective To introduce and discuss the clinicopathological features in insular carcinoma of the thyroid. Methods One newly found insular carcinoma of the thyroid,which was transformed from a follicular adenoma in eight years' history,was analysed by routine HE,immunohistochemical staining and literature review. Results Tumor tissue of the insular carcinoma consisted of uniformly poorly differentiated cells arranged in nests,islands and periepithelioid pattern based on viable cells that surrounded small vessels after prominent necrosis.Other growth patterns of insular carcinoma were compact,solid and microfollicular.The tumor cells were uniform in small size with mild atypia of nuclei,in which the prominent nucleoli and mitotic figures were not easily found.Recurrence and survival of the insular carcinoma were located between those of well-differentiated thyroid carcinoma and of anaplastic thyroid carcinoma in literature. Conclusion Iusular carcinoma is a histologically distinct subset of thyroid carcinoma,with characteristics between well-differentiated thyroid carcinoma and anaplastic thyroid carcinoma with respect to its morphologic,biologic and clinical behavior.