论文部分内容阅读
目的探讨甲状腺显示胸腺样分化的癌(CASTLE)临床病理、免疫表型、超微结构特征及生物学行为。方法回顾性分析9例CASTLE的临床病理资料,行免疫组化标记和电镜观察,并采用原位杂交法检测EBER表达情况。结果 CASTLE多发生于甲状腺下极,以膨胀性生长为主。肿瘤排列方式和细胞特点与发生于胸腺的鳞状细胞癌或淋巴上皮瘤样癌相似。免疫组化示9例肿瘤细胞CD5、CD117、p63、HMWK、GLUT-1、Pax8、E-cadherin、bcl-2和p53均(+),5例CAⅨ(+),6例CEA(+),3例神经内分泌标记(+)。超微结构显示肿瘤细胞含较多的线粒体及张力原纤维,细胞间桥粒丰富,其中1例胞质内见神经内分泌颗粒。随访4~65个月(平均31月),9例均健在,其中2例分别于首次术后18.5个月和22个月发生局部复发。结论 CASTLE是一种低度恶性的甲状腺癌,其组织学和免疫组化与胸腺癌相似。GLUT-1可作为CASTLE新的免疫标记物,与CD5、CD117联合检测有助于该肿瘤的确诊与鉴别。
Objective To investigate the clinicopathological features, immunophenotypes, ultrastructural features and biological behavior of thyroid-differentiated thymomas (CASTLE). Methods The clinicopathological data of 9 cases of CASTLE were retrospectively analyzed. The expression of EBER was detected by immunohistochemistry and electron microscopy. The expression of EBER was detected by in situ hybridization. CASTLE occurred in the lower pole of the thyroid, mainly to the expansion of growth. Tumor alignment and cellular features are similar to squamous cell carcinoma or lymphoepithelioma-like carcinomas that occur in the thymus. Immunohistochemistry showed that the expression of CD5, CD117, p63, HMWK, GLUT-1, Pax8, E-cadherin, bcl- Three neuroendocrine markers (+). The ultrastructure showed that the tumor cells contained more mitochondria and fibrils, and the desmosomes were abundant among them. Among them, 1 showed neuroendocrine granules in the cytoplasm. All the patients were followed up for 4 to 65 months (mean, 31 months). Nine patients were alive. Two of them were locally recurred at 18.5 months and 22 months after the first operation. Conclusion CASTLE is a low-grade thyroid carcinoma with similar histological and immunohistochemical characteristics as thymic carcinoma. GLUT-1 can be used as a new immunological marker of CASTLE, combined with CD5, CD117 detection contribute to the diagnosis and identification of the tumor.