Kondo Tetsuo, Kato Kunitaka, Nakazawa Tadao, Miyata Kazuyuki, Murata Shin-Ichi, Katoh Ryohei
Department of Pathology, University of Yamanashi, Yamanashi, Japan.
Hum Pathol. 2005 Jun;36(6):698-701. doi: 10.1016/j.humpath.2005.04.012.
We report on a case of mucinous carcinoma of the thyroid in an 82-year-old Japanese woman. The 3 x 2 x 2-cm thyroid tumor located in the patient's right lateral lobe was soft and yellowish gray on the cut section. Microscopically, the tumor was composed entirely of strands or solid clusters accompanied by extensive extracellular mucin. Extracellular mucin was positive with Alcian blue stain and negative with periodic acid-Schiff stain. Immunohistochemically, the tumor cells were positive for thyroglobulin, thyroid-specific transcription factor 1, and low-molecular-weight cytokeratin but negative for carcinoembryonic antigen, calcitonin, and high-molecular-weight cytokeratin. The MIB-1 labeling index was rather high (11%), and immunoexpression of p53 was detectable in the nuclei of carcinoma cells. From these findings, we classified the present tumor as a mucinous carcinoma of the thyroid (poorly differentiated thyroid carcinoma producing massive extracellular mucin). The patient died of multiple metastases 4 years after the initial operation.
我们报告了一例82岁日本女性的甲状腺黏液癌。位于患者右侧叶的3×2×2厘米甲状腺肿瘤，切面柔软，呈黄灰色。显微镜下，肿瘤完全由条索状或实性团块组成，并伴有大量细胞外黏液。细胞外黏液对阿尔辛蓝染色呈阳性，对过碘酸希夫染色呈阴性。免疫组化显示，肿瘤细胞甲状腺球蛋白、甲状腺特异性转录因子1和低分子量细胞角蛋白呈阳性，但癌胚抗原、降钙素和高分子量细胞角蛋白呈阴性。MIB-1标记指数相当高（11%），p53在癌细胞核中有免疫表达。根据这些发现，我们将目前的肿瘤分类为甲状腺黏液癌（产生大量细胞外黏液的低分化甲状腺癌）。患者在初次手术后4年死于多发转移。
