以骨转移为首发症状的甲状腺滤泡癌病理特征分析

Pathological features of follicular thyroid carcinoma with bone metastasis as the first symptom

目的探讨以骨转移为首发症状的甲状腺滤泡癌(follicular thyroid carcinoma,FTC)病理特征。方法收集解放军总医院病理科2008年4月-2014年4月28例甲状腺滤泡癌病例进行回顾性分析,比较以骨转移为首发症状的病例与同期非骨转移病例的病理特征。结果 28例FTC中,骨转移9例(32.1%),均以骨转移为首发症状,发生部位以中轴骨为主,男女比例1∶8,平均年龄62.6岁。非骨转移病例男女比例1∶2.8,平均年龄52.3岁。非骨转移FTC可出现嗜酸性变、透明变、血管浸润等多种形态特点,甚至发生肉瘤样变;转移FTC形态单一。结论 FTC易发生骨转移,部分病例常以骨转移为首发症状,FTC骨转移异型性小,如临床发现骨质破坏应排除FTC骨转移可能。

Objective To evaluate the pathological features of the follicular thyroid carcinoma （FTC） with bone metastasis as the first symptom. Methods Clinical data about 28 patients with FFC admitted to the department of pathology of Chinese PLA General Hospital from April 2008 to April 2014 were retrospectively analyzed, and pathological features were compared between cases with bone metastasis as the first symptom and cases without bone metastasis. Results Of the 28 cases with FTC, there were 9 cases with bone metastasis, and all of them made bone metastasis as the first symptom （32.1%） which occurred in the axial skeleton. In the cases of bone metastasis, the male to female ratio was 1：8 and the average age of the patients was 62.6 years old. In the cases without bone metastasis, the male to female ratio was 1：2.8 and the average age was 52.3 years old. FTC without metastasis might appear eosinophilic degeneration, hyaline degeneration, vascular invasion or even the sarcomatous change, and many other kinds of pathological features. However, FI＇C with metastasis had only one form. Conclusion PTC is susceptible to bone metastasis. Some patients with FTC have bone metastasis as the first symptom. PTC with bone metastasis has smaller atypia, and it should be excluded if bone destruction is found in clinical.