甲状腺副神经节瘤临床病理观察

Primary paraganglioma of the parathyroid: a clinicopathologic study

目的探讨甲状腺副神经节瘤的临床病理特征及鉴别诊断。方法收集1例甲状腺原发性副神经节瘤的临床资料,观察组织病理学形态、免疫组化染色及特殊染色,并复习相关文献。结果患者女性,36岁。因颈部肿物入院。肿块大体为包膜完整的实性结节。镜下肿瘤由2种类型细胞构成,即多边形主细胞和位于主细胞周边的梭形支持细胞。肿瘤细胞排列成特征性的巢状或球状结构,之间为纤维血管性间质。免疫组化:主细胞CgA、Syn、NSE和蛋白基因产物9.5(PGP9.5)(+),AE1/AE3和EMA(-);支持细胞S-100(+)。特殊染色:刚果红染色(-)。结论甲状腺原发性副神经节瘤是一种罕见的肿瘤,确诊需要依靠病理检查及免疫组化标记,需与甲状腺其他实性肿瘤鉴别。

Objective To investigate the clinicopathologic features and the differential diagnosis of paraganglioma of the thyroid gland.Methods One case of paraganglioma of the thyroid gland was reported,combined with literature review on its clinical presentation,morphology,immunohistochemistry,and specific stains.Results The patient was female,aged 36 years,and saw doctor for a neck mass.Gross examination showed a solid mass with intact envelope.Microscopically,the tumor with a nesting pattern （＂zellballen＂）,was composed of chief cell and sustentacular cell,the stroma was santy,with numorous blood vessels.Immunohistochemically,the chief cells were positive for CgA,Syn,NSE and PGP9.5,and negative for AE1/AE3 and EMA ; the sustentacular cells were positive for S100.Congo red staining was negative.Conclusions Primary paraganglioma of the parathyroid is a rare rumor and its correct diagnosis relies on pathological examination and immunohistochemical staining,and it is also needed to differentiate from other parathyroid tumor,especially medullary carcinoma.