甲状腺转移性肾透明细胞癌1例报道并文献复习

Renal clear cell carcinoma thyroid metastasis:a case report and literature review

目的探讨甲状腺转移性肾透明细胞癌(clear cell renal carcinoma,CCRC)的临床病理学特征。方法结合文献复习,对1例甲状腺转移性肾透明细胞癌的组织病理学、免疫组织化学特点进行分析。结果本例患者为72岁老年女性,发现甲状腺肿物1月入院。彩超检查示:双侧甲状腺结节。大体:肿瘤切面灰黄色,质中,包膜完整。镜下:肿瘤细胞呈圆形,胞浆透亮,核小而圆,排列呈巢状和腺泡状,间质纤维组织较少,有血窦散在。免疫表型:瘤细胞主要表达CD10,CK(L),EMA,Vimentin,Ki-67增殖指数约5%。结论甲状腺转移性CCRC为一种较少见的肿瘤,患者通常起病隐匿,易误诊,需通过病理组织学观察及免疫组织化学标记为其正确诊断提供可靠方法。

Objective To investigate the clinicopathological features of renal clear cell carcinoma （CCRC） metastatic to thyroid gland. Methods A thyroid metastasis from renal clear cell carcinoma case was analyzed using histopathology and immunohistochemistry combined with literature review. Results The patient was a 72-year-old female with thyroid nodule identified for a month. Color Doppler ultrasonography examination showed bilateral thyroid nodules. Gross pathologic examination revealed grayish yellow tumor in complete capsule with medium texture. Histologic examination indicated tumor cells with clear cytoplasm, small and round nucleus, nested and acinar growth pattern, few interstitial fibrous tissue, and scattered sinusoid-like vascularity. Immunohistochemistry examination showed tumor cells were CD10, CK （L）, EMA and vimentin positive with 5% of Ki-67 proliferation index. Conclusion CCRC thyroid metastasis is a rare tumor with which patients usually have concealed symptoms and are misdiagnosed easily. Combination of histopathology and immunohistochemistry provide a reliable method for a correct diagnosis.