Albores-Saavedra J, Sharma S
Division of Anatomic Pathology, The University of Texas Southwestern Medical Center, Dallas 75390-9073, USA.
Mod Pathol. 2001 Feb;14(2):98-104. doi: 10.1038/modpathol.3880263.
Poorly differentiated thyroid carcinomas with follicular cell phenotype are not well defined. Different diagnostic criteria have been employed for these tumors, including solid growth, nodular, trabecular, and insular patterns. Cytologic features, such as a predominance of tall and columnar cells, have been considered to be diagnostic of poorly differentiated carcinoma. However, there is no agreement among surgical pathologists regarding morphologic criteria for poorly differentiated thyroid carcinoma. We report two unique thyroid neoplasms that we interpreted as poorly differentiated follicular carcinomas. Nodular, trabecular, and sheetlike patterns predominated in both tumors. They were composed of cells that were focally immunoreactive for thyroglobulin and had large vesicular nuclei with prominent nucleoli. A variable number of cells showed rhabdoid phenotype. The rhabdoid inclusions did not stain for thyroglobulin but contained whorls of intermediate filaments that were vimentin positive. There were foci of necrosis and numerous mitotic figures. Both patients were adults and died with multiple pulmonary metastases. The presence of rhabdoid cells in poorly differentiated follicular carcinomas broadens the spectrum of tumors with rhabdoid phenotype. More cases are needed to determine whether the rhabdoid phenotype is a marker for poorly differentiated follicular carcinoma as well as an independent adverse prognostic factor.
具有滤泡细胞表型的低分化甲状腺癌尚无明确的定义。针对这些肿瘤采用了不同的诊断标准，包括实性生长、结节状、小梁状和岛状结构。细胞学特征，如高柱状细胞占优势，被认为可诊断为低分化癌。然而，手术病理学家对于低分化甲状腺癌的形态学标准尚未达成共识。我们报告了两例独特的甲状腺肿瘤，我们将其诊断为低分化滤泡癌。两例肿瘤均以结节状、小梁状和片状结构为主。它们由对甲状腺球蛋白呈局灶性免疫反应的细胞组成，细胞核大呈泡状，核仁明显。可变数量的细胞表现出横纹肌样表型。横纹肌样包涵体对甲状腺球蛋白不着色，但含有波形蛋白阳性的中间丝漩涡。存在坏死灶和大量有丝分裂象。两名患者均为成年人，死于多发肺转移。低分化滤泡癌中横纹肌样细胞的存在拓宽了具有横纹肌样表型肿瘤的范围。需要更多病例来确定横纹肌样表型是否是低分化滤泡癌的标志物以及一个独立的不良预后因素。
