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目的:探讨甲状腺具有胸腺特征的癌的临床病理特征。方法:光镜观察及免疫组化染色。结果:6 例均为男性,最大67岁,最小38 岁( 平均45 岁) 。症状主要为颈部包块、声嘶或呼吸困难。6 例中3 例位于甲状腺右叶,3 例位于甲状腺左叶。肿瘤境界清楚,切面灰白色,部分呈结节状。光镜下肿瘤细胞呈结节状或条索状排列。瘤细胞巢或条索周围可见成熟的淋巴细胞浸润。局部可见鳞化或“哈氏”小体样结构。6 例中3 例术后无复发,迄今存活期分别为6 年、8 年及14 年。2 例分别于术后2 年及2 年半复发,但经二次手术后均得以很好控制,迄今存活已9 年及11 年。另1 例术后半年复发,术后2 年因肺转移死亡。结论:甲状腺具有胸腺特征癌不同于甲状腺其他类型的癌,其预后很好。
Objective: To investigate the clinicopathological characteristics of thyroid carcinoma with thymus characteristics. Methods: Light microscopy and immunohistochemical staining. Results: All 6 cases were male, maximum 67 years old and minimum 38 years old (average 45 years old). Symptoms are mainly neck mass, hoarseness, or difficulty breathing. Of the 6 cases, 3 were located in the right thyroid lobe and 3 were located in the left thyroid lobe. The tumor realm is clear, the cut surface is gray and white, and some are nodular. The tumor cells were nodular or cord-shaped under light microscope. Mature lymphocytes infiltrate around nests or cords of tumor cells. Localized scaled or “Hakis” small body-like structures can be seen locally. Three of the 6 patients had no recurrence after surgery, and the survival times so far were 6, 8, and 14 years, respectively. Two cases recurred at 2 years and 2 years after surgery, but they were well controlled after the second operation and have survived for 9 years and 11 years. The other case recurred six months after surgery and died of lung metastasis 2 years after surgery. Conclusion: The thyroid has a characteristic thymus cancer that is different from other types of thyroid cancer and has a good prognosis.