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目的探讨甲状腺乳头状癌嗜酸细胞变异型伴桥本甲状腺炎的病理形态学特征。方法对1例甲状腺乳头状癌嗜酸细胞变异型伴桥本甲状腺炎进行病理形态学及免疫组化分析,复习该病变的相关文献并讨论其诊断及鉴别诊断要点。结果组织学形态主要表现为乳头状癌间质中有大量淋巴细胞、浆细胞浸润,癌细胞嗜酸性变。免疫组化示肿瘤组织CK19、HBME-1、CK、TG、TTF-1和EMA呈弥漫或大部分(+),calcitonin、p53和Ki-67均(-)。结论甲状腺乳头状癌嗜酸细胞变异型伴桥本甲状腺炎具有比较独特的组织学形态,在临床病理诊断中很容易误诊为桥本甲状腺炎伴滤泡上皮嗜酸变等形态结构相近的良、恶性病变。形态学上乳头状癌癌细胞特征性核改变及免疫组化CK19和HBME-1(+)有助于其诊断和鉴别诊断。
Objective To investigate the pathomorphological features of papillary thyroid carcinoma with eosinophilic variant Hashimoto’s thyroiditis. Methods One case of papillary thyroid carcinoma with eosinophilic variant Hashimoto’s thyroiditis was analyzed by pathomorphology and immunohistochemistry. The related literature of the lesion was reviewed and its diagnostic and differential diagnosis points were discussed. Results Histology showed that there were a large number of lymphocytes, plasma cells infiltration, and eosinophilicity of cancer cells in the interstitium of papillary carcinoma. Immunohistochemistry showed that the tumor tissues CK19, HBME-1, CK, TG, TTF-1 and EMA were diffuse or mostly (+), calcitonin, p53 and Ki-67 were all (-). Conclusion Papillary thyroid carcinoma eosinophil variant Hashimoto’s thyroiditis has a unique histological morphology, which is easily misdiagnosed as Hashimoto’s thyroiditis associated with follicular eosinophilic morphological structure in clinicopathological diagnosis. Malignant lesions. Morphological morphological changes of papillary carcinoma cells and immunohistochemistry of CK19 and HBME-1 (+) contribute to its diagnosis and differential diagnosis.