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低分化甲状腺癌的临床病理

孙健,  李文波,  杨堤,  成殷,  崔全才

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文章导航 > 协和医学杂志  > 2012 >  3(1): 72-76
孙健, 李文波, 杨堤, 成殷, 崔全才. 低分化甲状腺癌的临床病理[J]. 协和医学杂志, 2012, 3(1): 72-76. doi: 10.3969/j.issn.1674-9081.2012.01.016
引用本文: 孙健, 李文波, 杨堤, 成殷, 崔全才. 低分化甲状腺癌的临床病理[J]. 协和医学杂志, 2012, 3(1): 72-76. doi: 10.3969/j.issn.1674-9081.2012.01.016
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Jian SUN, Wen-bo LI, Di YANG, Yin CHENG, Quan-cai CUI. Clinicopathological Characteristics of Poorly Differentiated Thyroid Carcinoma[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(1): 72-76. doi: 10.3969/j.issn.1674-9081.2012.01.016
Citation: Jian SUN, Wen-bo LI, Di YANG, Yin CHENG, Quan-cai CUI. Clinicopathological Characteristics of Poorly Differentiated Thyroid Carcinoma[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(1): 72-76. doi: 10.3969/j.issn.1674-9081.2012.01.016
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低分化甲状腺癌的临床病理

doi: 10.3969/j.issn.1674-9081.2012.01.016
  • 1.

    中国医学科学院 北京协和医学院 北京协和医院 病理科, 北京 100730

  • 2.

    中国医学科学院 北京协和医学院 北京协和医院 超声诊断科, 北京 100730

详细信息
    通讯作者:

    崔全才 电话:010-65295520, Email:cuiqc@sina.com

  • 中图分类号: R736.1;R446.8

Clinicopathological Characteristics of Poorly Differentiated Thyroid Carcinoma

  • 1.

    Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 2.

    Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

More Information
    Corresponding author: CUI Quan-cai Tel: 010-65295520, Email:cuiqc@sina.com

    摘要
  • 摘要:   目的  观察低分化甲状腺癌(poorly differentiated thyroid carcinoma, PDTC)的临床病理特点。  方法  回顾性分析北京协和医院12例符合都灵诊断共识的PDTC临床、影像和病理学资料, 并采用EnVision法进行免疫组织化学标记。  结果  12例PDTC病例中11例为女性, 1例为男性, 平均发病年龄53.6岁。临床均表现为前颈部肿块, B超示肿物为低回声实性结节。5例患者肿瘤主要呈粱状生长, 4例主要呈岛状生长, 3例主要呈实性生长。免疫组化, 11例阳性表达TTF1;10例阳性表达甲状腺球蛋白; 4例P53弥漫阳性表达, 3例局灶阳性表达; Ki67增殖指数3%~25%不等。随访期间, 2例患者分别于术后4年及术后7.5年死于肿瘤播散。  结论  PDTC是一种独特的且较少见的甲状腺恶性肿瘤, 其临床病理特点介于高分化甲状腺癌与未分化甲状腺癌之间。
    Abstract:   Objective  To investigate the clinicopathological characteristics of poorly differentiated thyroid carcinoma (PDTC).  Methods  The clinical and pathological features as well as the imaging findings of 12 cases of PDTC were retrospectively reviewed.  Results  The 12 patients, 1 man and 11 women, with an average age of 53.6 years, presented with painless mass at the anterior neck. Grossly, the tumor had a nodular appearance. Histologically, the predominantly insular pattern was found in 4 tumors, the trabecular architecture in 5 tumors, and the solid flake architecture in 3 tumors. Immunohistochemically, TTF1 was positive in 11 cases. Thyroglobulin expression was noted in 10 cases. P53 immunostaining showed diffuse positivity in 4 cases and focal positivity in 3 cases. The Ki67 proliferative index ranged from 3% to 25%. Two patients died of the tumor progression 4 and 7.5 years after the surgery, respectively.  Conclusion  PDTC is a rare disease with clinicopathological characteristics intermediate between follicular/papillary and anaplastic carcinomas.
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  • 图  1  呈岛状结构低分化甲状腺癌, 肿瘤细胞团被含细小血管的薄层纤维组织围绕并以此为间隔形成境界清楚的岛状分布(HE, ×150)

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    图  2  呈梁状结构低分化甲状腺癌, 肿瘤细胞排成索状或缎带状(HE, ×60)

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    图  3  呈实性结构低分化甲状腺癌, 肿瘤细胞密集排列形成大片状实体无结构区域(HE, ×300)

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    图  4  低分化甲状腺癌肿瘤组织内见较多核分裂(HE, ×300)

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    图  5  低分化甲状腺癌肿瘤细胞团中央见典型的肿瘤性坏死(HE, ×150)

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    图  6  具有核扭曲特征的低分化甲状腺癌, 细胞核较小且深染, 具有不规则核膜, 无毛玻璃样核及核内包涵体(HE, ×300)

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    图  7  免疫组化染色示1例低分化甲状腺癌标本中约50%肿瘤细胞P53呈阳性表达, 细胞核呈中等强度着色(HE, × 300)

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    图  8  免疫组化染色示1例低分化甲状腺癌标本中Ki 67增殖活性指数约为8%(HE, ×300)

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    表  1  12例低分化甲状腺癌患者临床病理特点
    • 参考文献(15)
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出版历程
  • 收稿日期:  2011-10-25
  • 刊出日期:  2012-01-30

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