Hirokawa Mitsuyoshi, Kuma Seiji, Miyauchi Akira, Qian Zhi Ring, Nakasono Masahiko, Sano Toshiaki, Kakudo Kennichi
Department of Pathology, University of Tokushima School of Medicine, Kuramoto-cho, Japan.
APMIS. 2004 Apr-May;112(4-5):275-82. doi: 10.1111/j.1600-0463.2004.apm11204-0508.x.
Morules are a diagnostic clue to the cribriform-morular variant (C-MV) of papillary thyroid carcinoma, and are superficially similar to squamous metaplasia. In order to clarify the histogenesis of morules and differentiate them from squamous metaplasia, we immunohistochemically compared the morules in five cases of C-MV with squamous metaplasia in six cases of diffuse sclerosing variant (DSV) of papillary thyroid carcinoma. The squamous metaplastic cells were immunopositive for low- and high-molecular-weight cytokeratin, whereas the morular cells were negative or focally positive. Vimentin-positive cells were observed focally in the morules and squamous metaplasia, except for one case of CMV that showed intense positivity. The morular cells showed weak cytoplasmic positivity for beta-catenin, and the cell membrane was not highlighted. Some nuclei of the morular cells were also positive for this antibody. Beta-catenin was intensively positive along the cell membrane of the metaplastic cells, and did not react against the nuclei or cytoplasm. Bcl-2 was positive in the morular cells, but negative in the metaplastic cells. S-100 protein-positive dendritic cells were observed in the metaplastic nests, but not in the morules. We argue that morules appear in connection with nuclear and cytoplasmic aberrant localization of beta-catenin, and are not an early form of squamous metaplasia.
桑葚体是甲状腺乳头状癌筛状-桑葚体变异型（C-MV）的诊断线索，且在表面上与鳞状化生相似。为了阐明桑葚体的组织发生并将其与鳞状化生区分开来，我们采用免疫组织化学方法，将5例C-MV中的桑葚体与6例甲状腺乳头状癌弥漫硬化变异型（DSV）中的鳞状化生进行了比较。鳞状化生细胞对低分子量和高分子量细胞角蛋白呈免疫阳性，而桑葚体细胞为阴性或局灶性阳性。波形蛋白阳性细胞在桑葚体和鳞状化生中局灶性观察到，除1例C-MV显示强阳性外。桑葚体细胞对β-连环蛋白呈弱细胞质阳性，细胞膜未被突出显示。桑葚体细胞的一些细胞核对该抗体也呈阳性。β-连环蛋白在化生细胞的细胞膜上呈强阳性，对细胞核或细胞质无反应。Bcl-2在桑葚体细胞中呈阳性，但在化生细胞中呈阴性。在化生巢中观察到S-100蛋白阳性的树突状细胞，但在桑葚体中未观察到。我们认为，桑葚体的出现与β-连环蛋白的核和细胞质异常定位有关，并非鳞状化生的早期形式。
