Bayer-Garner I B, Kozovska M E, Schwartz M R, Reed J A
Marshfield Clinic, Marshfield, WI 54449, USA.
J Cutan Pathol. 2004 Oct;31(9):625-9. doi: 10.1111/j.0303-6987.2004.00235.x.
Carcinoma exhibiting thymus-like differentiation (CASTLE) is a rare, distinct tumor of the thyroid gland or soft tissue of the head and neck that may simulate primary squamous cell carcinoma or lymphoepithelioma, and which contains features reminiscent of thymic differentiation including Hassall's corpuscles, occasional perivascular spaces, and the presence of lymphocytes. Ectopic thymic tissue may result from incomplete descent or persistence of the cervical portion of the thymus and may occur anywhere along the course of the embryonic descent from the angle of the mandible to the sternal notch. Herein, we report two cases of dermal extrathyroidal CASTLE. The differential diagnosis of squamoid carcinoma with features of thymic differentiation includes extrathyroidal CASTLE, a primary squamous cell carcinoma with thymic differentiation, lymphoepithelioma-like carcinoma of the skin, and metastatic squamous cell carcinoma of unknown primary. It is essential that the latter two be ruled out before accepting the diagnosis of an extrathyroidal carcinoma with thymus-like differentiation.
具有胸腺样分化的癌（CASTLE）是一种罕见的、独特的甲状腺或头颈部软组织肿瘤，可能类似原发性鳞状细胞癌或淋巴上皮瘤，并且具有让人联想到胸腺分化的特征，包括哈氏小体、偶尔的血管周围间隙以及淋巴细胞的存在。异位胸腺组织可能是由于胸腺颈部部分下降不完全或持续存在所致，可发生在从下颌角到胸骨切迹的胚胎下降过程中的任何位置。在此，我们报告两例皮肤甲状腺外CASTLE病例。具有胸腺分化特征的鳞状细胞癌的鉴别诊断包括甲状腺外CASTLE、具有胸腺分化的原发性鳞状细胞癌、皮肤淋巴上皮瘤样癌以及原发灶不明的转移性鳞状细胞癌。在接受具有胸腺样分化的甲状腺外癌的诊断之前，排除后两者至关重要。
