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目的探讨显示胸腺样分化的癌(CASTLE)的临床病理学特征、诊断与鉴别诊断、治疗与预后。方法分析2例显示胸腺样分化的癌的临床表现、组织形态学及免疫组化特征,并进行观察及文献复习。结果临床主要表现为颈部肿块,肿物活动度差、质硬,与周围组织界限不清。镜下肿瘤细胞成片状、巢状、岛状排列,肿瘤细胞间常伴有淋巴细胞浸润,颇像原发于甲状腺的鳞状细胞癌。免疫组化:肿瘤细胞CK、CD5、CD117和bcl-2均(+)。结论CASTLE是一种低度恶性肿瘤,非常少见,常常被误诊为发生于甲状腺的鳞状细胞癌,故将两者鉴别开来十分必要。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis, treatment and prognosis of thymus-like carcinoma (CASTLE). Methods The clinical manifestations, histomorphology and immunohistochemical features of 2 cases of thymic-differentiated carcinoma were observed and reviewed. Results The main clinical manifestations of the neck mass, tumor activity was poor, hard, and the surrounding tissue unclear. Microscopic tumor cells into a sheet, nests, island-like arrangement, often accompanied by tumor cell infiltration of lymphocytes, rather like primary thyroid squamous cell carcinoma. Immunohistochemistry: The tumor cells CK, CD5, CD117 and bcl-2 (+). Conclusion CASTLE is a low-grade malignant tumor. It is very rare and often misdiagnosed as squamous cell carcinoma in the thyroid gland. Therefore, it is necessary to distinguish the two.