摘要
目的报道甲状腺伴嗜酸细胞增多的硬化型黏液表皮样癌(SMECE)临床病理学特点。方法总结1例甲状腺SMECE的组织病理学及免疫组化特点,结合文献讨论其组织发生及鉴别诊断。结果肿瘤境界不清,灰白色,中心坏死囊性变。镜下见在硬化的纤维组织背景上出现条索状、片状的鳞状细胞巢和不典型腺样结构,瘤细胞温和,并伴有多量嗜酸性粒细胞、淋巴细胞浸润。周围甲状腺组织呈淋巴细胞/桥本甲状腺炎表现。免疫组化:瘤细胞CK、EMA和p63(+),Tg、TTF-1及calcitonin(-)。结论SMECE是罕见的甲状腺低度恶性肿瘤。其形态学温和,但局部呈侵袭性生长,常转移至颈部淋巴结。SMECE可能是甲状腺滤泡上皮经鳞状细胞化生后衍化而来。主要与甲状腺伴鳞状细胞化生的良性病变、鳞状细胞癌及一些少见低度恶性肿瘤鉴别诊断。
Objective To explore the clinicopathologic features of thyroid sclerosing mucoepidermoid carcinoma with eosinophiha （SMECE）. Methods Histopathologic features and immunohistochemical findings of one case of SMECE were summarized. The histogenesis and differential diagnosis of SMECE were discussed with review of the literature. Results Macroseopically, the thyroid gland showed a poorly-circumscribed grey-white mass with central necrosis and cyst formation. Histopathologically, prominent cords and nests of squamoid cells and some gland-hke structures showed mild atypia with the surrounding sclerotic stroma containing a lot of eosinophils and lymphocytes. The tumor cells were positive for CK（AE1/AE3）, EMA and P63 but negative for Tg, TTF-1 and calcitonin. Conclusion SMECE is a rare and distinctive low-grade neoplasm of thyroid. It appears local aggressive growth pattern and cervical lymph nodes metastasis. SMECE seems to arise from the squamous metaplasia of the thyroid. The differential diagnosis includes some benign lesions with squamous metaplasia, squamous cell carcinoma as well as other rare low-grade malignant tumors.
出处
《诊断病理学杂志》
CSCD
2008年第6期441-444,共4页
Chinese Journal of Diagnostic Pathology
