包膜内浸润并有乳头状癌核特点的甲状腺滤泡性肿瘤3例临床病理观察

Clinicopathological features of thyroid follicular tumors with intracapsular infiltration and papillary carcinomatous nuclei:report of three cases

目的探讨包膜内浸润(未突破包膜)并有乳头状癌核特点的甲状腺滤泡性肿瘤的临床病理学特征。方法对3例有包膜内浸润并有乳头状癌核特点的甲状腺滤泡性肿瘤进行组织学及免疫表型分析,并复习相关文献。结果3例患者中,2例女性,1例男性。巨检:肿瘤直径0.8~1.2 cm,界限清楚,切面灰白色,质中。镜检:有包膜内浸润和甲状腺乳头状癌的核特征,无乳头状结构。免疫组化:肿瘤细胞CK19弥漫(+),Galectin-3和HBMB-1部分(+),BRAF(VE1)和CD56(-),Ki-67增殖指数约2%。结论包膜内浸润并有乳头状癌核特点的甲状腺滤泡性肿瘤,其诊断需要结合组织学形态和免疫表型,并需与滤泡癌、甲状腺乳头状癌鉴别。

Objective To investigate the clinicopathological characteristics of thyroid follicular tumors with intracapsular infiltration(not breaking through the capsule)and papillary carcinomatous nuclei.Methods Three cases were analyzed by histology and immunophenotype,and the available literature on this subject was reviewed as well.Results There were two female and one male patients.On macroscopic examination,tumors were 0.8-1.2 cm in diameter and clear boundary with gray and quality on cut surface.Microscoically,the tumors with nuclear features of papillary thyroid carcinoma and no papillary structure invaded into the acapsule.Immunohistochemically,tumor cells were diffuse strongly positive for CK19,and Galectin-3;HBMB-1 were partially positive,BRAF(VE1)and CD56 were negative;Ki-67 was about 2%.Conclusions The diagnosis of thyroid follicular tumors with infiltrating capsule and nuclear features of papillary carcinoma needs to be combined with histological morphology and immunophenotype,and it should be distinguished from follicular carcinoma and papillary thyroid carcinoma.