鼻咽部原发性甲状腺样低级别乳头状腺癌临床病理学特征

Clinicopathological features of primary thyroid-like low-grade papillary adenocarcinoma of the nasopharynx

目的分析鼻咽部原发性甲状腺样低级别乳头状腺癌(TL-LGNPPA)临床病理学特征。方法筛选2018年2月~2021年10月入本院治疗的TL-LGNPPA患者4例作为研究对象,回顾性分析其临床表现、组织学形态、免疫表型等资料。结果4例患者2例女性、2例男性,年龄在44-67岁之间,肿瘤直径长0.2-2.5cm,均实施手术切除治疗。4例患者肿物均位于鼻咽顶部,并呈外生性息肉状生长,在镜下观察可发现肿瘤由乳头状结构、管状腺体组成。4例患者肿瘤细胞核均呈圆形或卵圆形,形态一致、相对温和。免疫组化显示:4例患者CK(pan)、CK7、CK19、EMA、Vimentin、TTF-1呈阳性表达,CK5/6、CK20、S-100、CEA、TG、P63、Napsin A、SMA、CD15均不表达,随访1年、4年均未见复发及转移情况。结论鼻咽部原发性甲状腺样低级别乳头状腺癌在临床发病率较低,但经形态学及免疫组化检查便可明确诊断,而后实施手术切除治疗,可减少疾病对患者生活质量的影响。

Objective To analyze the clinicopathological features of primary thyroid-like low-grade papillary adenocarcinoma of the nasopharynx(TL-LGNPPA).Methods Four TL-LGNPPA patients admitted to our hospital from February 2018 to October 2021 were selected as the research objects,and their clinical manifestations,histological morphology,immunophenotype and other data were retrospectively analyzed.Results 4 patients,2 females and 2 males,aged between 44-67 years,with a tumor diameter of 0.2-2.5 cm,all underwent surgical resection.The tumors in 4 patients were all located at the top of the nasopharynx,and showed exophytic polypoid growth.Microscopically,it was found that the tumors consisted of papillary results and tubular glands.The nuclei of tumor cells in 4 patients were all round or oval,with consistent and relatively mild shape.Immunohistochemistry showed:4 patients were positive for CK(pan),CK7,CK19,EMA,Vimentin,TTF-1,CK5/6,CK20,S-100,CEA,TG,P63,Napsin A,SMA,CD15 No expression was found,and no recurrence and metastasis were found in the 1-year and 4-year follow-up.Conclusion The clinical incidence of primary thyroid-like low-grade papillary adenocarcinoma in the nasopharynx is low,but the diagnosis can be confirmed by morphological and immunohistochemical examination,and then surgical resection can reduce the impact of the disease on the quality of life of patients.Impact.