柱状细胞亚型甲状腺乳头状癌4例临床病理分析

Clinicopathologic analysis of 4 cases of columnar cell variant of papillary thyroid carcinoma

为探讨柱状细胞亚型甲状腺乳头状癌(columnar cell variant of papillary thyroid carcinoma,CCV-PTC)的临床病理学特征及生物学行为,本文收集分析4例CCV-PTC的临床资料,观察其病理学特征及免疫表型。4例患者中,男2例,女2例,年龄54~81(平均63)岁。1例男性患者可见周围横纹肌组织受累及肺组织转移;1例男性患者可见被膜侵犯,并见颈深下区及中央区淋巴结转移;1例女性患者伴低分化癌。组织学检查结果示:肿瘤细胞呈柱状,假复层排列,部分肿瘤细胞可见核上/核下空泡样变,类似分泌形态子宫内膜。免疫表型:TTF-1(+),CK19(+),TG(+),BRAF^V600E(+)。CCVPTC属于甲状腺乳头状癌的一种罕见亚型,与经典型甲状腺乳头状癌相比更具侵袭性,根据其组织学特点,并结合免疫表型即可诊断。

To investigate the clinicopathological features and biological behavior of columnar cell variant of thyroid papillary carcinoma(CCV-PTC),the clinical data of 4 cases of CCV-PTC were collected and analyzed.The pathological features and immunophenotypes of CCV-PTC were observed.Two female and two male among the four patients,with an average age of 63 years(range,54–81 years).Peripheral striated muscle invasion and lung metastasis were found in the male patient.Capsule invasion and lymph node metastasis in the deep inferior and central region of the neck were found in another male patient.And the female patient was accompanied by poorly differentiated carcinoma.The histologic features showed the tumor cells were columnar and pseudostratified,and occasional showed supranuclear/subnuclear vacuolization,similar to the secretory form of the endometrium.The immunohistochemistry of the columnar cells showed positive of TTF-1,CK19,TG and BRAF^V600E.CCV-PTC is a rare subtype of papillary thyroid carcinoma,which is more invasive than classical papillary thyroid carcinoma.It can be diagnosed according to its histologic characteristics and immunophenotypes.