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目的探讨甲状腺透明细胞型乳头状癌的临床病理特征、免疫表型、诊断及鉴别诊断要点。方法对1例甲状腺肿瘤的临床病理资料进行光镜观察及免疫组化和AB-PAS染色,并复习相关文献。结果患者女性,60岁。肿瘤位于甲状腺峡部,大体呈结节状,似有完整包膜,切面五彩状,可见黏液及钙化。组织学见肿瘤由充满胶质或稀薄黏液的滤泡结构和实性片状区域构成,未见明确乳头结构,但可见泡状核、核沟及核内假包涵体,引人注目的是实性区域部分细胞胞质透明。免疫组化显示TTF-1、Tg、galectin-3和CK19(+),HBME-1、降钙素、CD10、RCC和vimentin(-)。特殊染色:AB-PAS(+)。结论甲状腺透明细胞型乳头状癌是甲状腺乳头状癌的罕见亚型,组织形态学易与转移性肾透明细胞癌混淆,免疫组化及PAS染色有助于二者的鉴别。
Objective To investigate the clinicopathological characteristics, immunophenotype, diagnosis and differential diagnosis of clear cell papillary thyroid carcinoma. Methods The clinical and pathological data of one case of thyroid tumor were observed by light microscopy and immunohistochemistry and AB-PAS staining. The related literatures were reviewed. Results Female patient, 60 years old. The tumor is located in the thyroid isthmus, roughly nodular, seems to have a complete capsule, section multicolored, visible mucus and calcification. Histologically, the tumor was composed of follicular structures and solid lamellar regions filled with glial or lean mucus. There was no definite papillary structure, but bubbly nuclei, nuclear ditch and intranuclear false inclusions were visible, Sexual area part of the cell cytoplasm transparent. Immunohistochemistry showed that TTF-1, Tg, galectin-3 and CK19 (+), HBME-1, calcitonin, CD10, RCC and vimentin (-). Special stain: AB-PAS (+). Conclusions Thyroid clear cell papillary carcinoma is a rare subtype of papillary thyroid carcinoma. Its histological morphology is easily confused with metastatic renal clear cell carcinoma. Immunohistochemical staining and PAS staining are helpful for the identification of the two.