Van Savell H, Hughes Stephen M, Bower Charles, Parham David M
Department of Pathology, Arkansas Children's Hospital, 800, Little Rock, AR 72202, USA.
Pediatr Dev Pathol. 2004 Sep-Oct;7(5):487-92. doi: 10.1007/s10024-003-3028-3. Epub 2004 Jul 30.
Lymphocytic thyroiditis has been associated with an increase in the incidence of thyroid papillary carcinoma in some reports, mostly series of both adults and children. Relatively little is written about thyroiditis and follicular carcinomas. We have seen several cases of pediatric follicular thyroid carcinomas, that had an associated lymphocytic infiltrate, which led us to examine all primary malignant thyroid neoplasms in our surgical files from 1984 through 2000 to examine this relationship. We also investigated the nature of the lymphocytic infiltrate with routine immunohistochemistry. Ten patients (five male, five female, ages 4.5-21 years of age) had a thyroid carcinoma resection, six (three males and three females) with papillary carcinoma and four patients (two males and two females) with low-grade follicular carcinoma. Seven samples (one male had two cases with tumor) from patients who had a papillary carcinoma resection with tissue blocks available were identified (one patient had slides but no blocks), as were all four patients with a follicular carcinoma. The thyroid of all patients with a follicular carcinoma contained a lymphocytic infiltrate; only four of the seven papillary carcinoma samples had an associated lymphoid infiltrate. In all cases with a lymphoid infiltrate, the infiltrate was present in both lobes (both adjacent and separate from the tumor). B lymphocytes were present in the lymphoid infiltrate of three of four patients with follicular carcinomas and in 1 of 3 cases of papillary carcinomas. T cells were dispersed throughout all the tumors with lymphoid infiltrates. We conclude that pediatric follicular carcinomas have an associated lymphocytic infiltrate in the tumor and/or adjacent thyroid, more commonly than papillary carcinomas.
在一些报告中，淋巴细胞性甲状腺炎与甲状腺乳头状癌发病率的增加有关，大多数报告涵盖了成人和儿童病例。关于甲状腺炎与滤泡状癌的相关文献相对较少。我们见过几例小儿滤泡状甲状腺癌病例，伴有淋巴细胞浸润，这促使我们检查了1984年至2000年手术档案中所有原发性甲状腺恶性肿瘤，以研究这种关系。我们还通过常规免疫组织化学研究了淋巴细胞浸润的性质。10例患者（5男5女，年龄4.5 - 21岁）接受了甲状腺癌切除术，其中6例（3男3女）为乳头状癌，4例（2男2女）为低级别滤泡状癌。确定了7例（1名男性有2例肿瘤）有可用组织块的乳头状癌切除患者的样本（1例患者有切片但无组织块），以及所有4例滤泡状癌患者的样本。所有滤泡状癌患者的甲状腺均有淋巴细胞浸润；7例乳头状癌样本中只有4例伴有淋巴细胞浸润。在所有有淋巴细胞浸润的病例中，浸润均存在于两叶（与肿瘤相邻及远离肿瘤处）。在4例滤泡状癌患者中的3例以及3例乳头状癌患者中的1例的淋巴细胞浸润中存在B淋巴细胞。T细胞散布于所有有淋巴细胞浸润的肿瘤中。我们得出结论，小儿滤泡状癌在肿瘤和/或相邻甲状腺中伴有淋巴细胞浸润的情况比乳头状癌更常见。
