甲状腺伴胸腺样分化的梭形细胞肿瘤临床病理观察

Spindle cell tumor with thymus-like differentiation of the thyroid:A case report and literature review

目的:探讨甲状腺伴胸腺样分化的梭形细胞肿瘤的临床病理学特征。方法:报道1例极少见的甲状腺伴胸腺样分化的梭形细胞肿瘤,并结合文献对其临床特征、组织形态、免疫组化特点及鉴别诊断等进行分析。结果:大体见4.5cm×3.5cm×2cm大小的灰白色结节,与周围界限较清。镜下见肿瘤主要为梭形细胞成分与腺样成分互相融合的双相分化表现。免疫表型Keratin、EMA和Vim阳性。结论:甲状腺伴胸腺样分化的梭形细胞肿瘤是一种非常少见的肿瘤,临床表现为无痛性肿块,无功能改变,确诊需结合组织形态及免疫组化。鉴别诊断包括甲状腺未分化癌、滑膜肉瘤、间质高度增生呈结节状筋膜炎样型甲状腺乳头状癌等。手术切除预后较好。

Objective ：To investigate the clinic pathological features of spindle cell tumor with thymus - like differ- entiation. Methods：To report a 67 year - old male with thyroid spindle cell tumor with thymus - like differentiation （SETI＇LE）, and evaluate the histo -morphologic, immunophenotypic and its clinical features. Results：Gross total resection of the tumor revealed a grayish - white tumor with a volume of 4.5cm× 3.5cm × 2cm,which had a clear boundary. Histologically, the tumor was composed of bundles of spindle cells showed thymic or typical branchial pouch differentiation. And the immunohistochemical analysis demonstrated that the tumor cells were immunoreaetive to Kera- tin and EMA. Conclusion：Spindle cell with thymuslike differentiation （SETYLE） is a very rare thyroid tumor, and the clinical manifestation were normally a painless lump in the neck. The histology, immunohistochemical results should be in use for its diagnosis. The tumor should be distinguished from thyroid undiferentiated carcinoma, synovial sarcoma,papillary carcinoma of the thyroid,etc.