Kondo Tetsuo, Nakazawa Tadao, Murata Shin-ichi, Katoh Ryohei
Department of Pathology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Japan.
Hum Pathol. 2005 May;36(5):474-9. doi: 10.1016/j.humpath.2005.03.006.
Stromal elastosis, defined as dense aggregations of elastic fibers, is found in some neoplastic tissues especially in malignant tumors of the breast and lung. Although also found in thyroid tissue, stromal elastosis in thyroid neoplasms have received little attention. To clarify the histopathological significance of stromal elastosis in the thyroid, we examined neoplastic (n = 223) and hyperplastic (n = 82) thyroid tissues in conjunction with cancer tissues (n = 193) of various other organs. Stromal elastosis was observed as deposits of pale homogeneous material in hematoxylin and eosin stain, and distinctively highlighted by elastic-van Gieson's stain. On immunohistochemical examination, elastin and tropoelastin were confirmed in these deposits. Stromal elastosis was found in 66% of papillary thyroid carcinomas (PTCs), although it was not identified in other histological types of thyroid neoplasms. In PTCs, deposits of elastic fibers varied in size and shape, and were more frequently distributed in the periphery of the tumor tissue. The histological subtypes of PTC varied in prevalence of elastosis with the follicular variant's (9%) prevalence being significantly lower than that of the classical type (72%). The frequency of stromal elastosis in PTCs was very similar to the frequencies in breast and lung adenocarcinomas, and higher than the frequencies in carcinomas of other organs. In conclusion, our results suggest that stromal elastosis is a characteristic histological finding of PTCs, presumably associated with their growth pattern and/or histological architecture. It is, therefore, reasonable to propose that stromal elastosis is an ancillary feature in the histopathological diagnosis of PTCs.
基质弹性组织变性，定义为弹性纤维的密集聚集，见于一些肿瘤组织，尤其是乳腺和肺部的恶性肿瘤。虽然在甲状腺组织中也有发现，但甲状腺肿瘤中的基质弹性组织变性很少受到关注。为阐明甲状腺中基质弹性组织变性的组织病理学意义，我们检查了肿瘤性（n = 223）和增生性（n = 82）甲状腺组织，并结合了其他各种器官的癌组织（n = 193）。在苏木精和伊红染色中，基质弹性组织变性表现为淡染均匀物质的沉积，在弹性-凡吉森染色中则显著突出。免疫组织化学检查证实这些沉积物中有弹性蛋白和原弹性蛋白。66%的甲状腺乳头状癌（PTC）中发现有基质弹性组织变性，而在其他组织学类型的甲状腺肿瘤中未发现。在PTC中，弹性纤维沉积物的大小和形状各异，且更频繁地分布于肿瘤组织周边。PTC的组织学亚型在弹性组织变性的发生率上有所不同，滤泡样变型的发生率（9%）显著低于经典型（72%）。PTC中基质弹性组织变性的频率与乳腺和肺腺癌中的频率非常相似，高于其他器官癌的频率。总之，我们的结果表明，基质弹性组织变性是PTC的一个特征性组织学表现，可能与其生长模式和/或组织结构有关。因此，提出基质弹性组织变性是PTC组织病理学诊断中的一个辅助特征是合理的。
