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具有横纹肌样表型的低分化甲状腺癌:诊断难题——1例罕见病例报告

Poorly differentiated thyroid carcinoma with rhabdoid phenotype: a diagnostic dilemma--report of a rare case.

作者信息

Agarwal S, Sharma M C, Aron M, Sarkar C, Agarwal N, Chumber S

机构信息

Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Endocr Pathol. 2006 Winter;17(4):399-405. doi: 10.1007/s12022-006-0011-3.

Abstract

Rhabdoid tumor is a distinct entity reported in renal and extrarenal sites. Malignant tumors of various types may have rhabdoid phenotype. There are eight case reports of carcinomas of thyroid with rhabdoid phenotype. All of these cases, except two, have been reported in middle-aged women (42-72 yr) and have had an aggressive clinical course with death occurring within few months to 4 yr after diagnosis. We report a case of poorly differentiated carcinoma of the thyroid with rhabdoid phenotype in a 22-yr-old male. The rhabdoid cells were immunopositive for thyroid transcription factor-1, vimentin, epithelial membrane antigen, and focally for cytokeratin. Synaptophysin, chromogranin, thyroglobulin, carcinoembryonic antigen, smooth muscle actin, myogenin, and desmin were all negative. To the best of our knowledge this is the ninth case report of carcinoma of the thyroid with rhabdoid phenotype. This case, unlike the previous reported cases, has certain unusual features including presentation in a young male, the absence of either follicular/papillary differentiation, and immunohistochemical profile of the rhabdoid cells.

摘要

横纹肌样瘤是一种在肾脏和肾外部位报道的独特实体。各种类型的恶性肿瘤可能具有横纹肌样表型。有8例甲状腺癌伴有横纹肌样表型的病例报告。除2例之外,所有这些病例均报道于中年女性(42 - 72岁),临床病程侵袭性强,诊断后数月至4年内死亡。我们报告1例22岁男性甲状腺低分化癌伴有横纹肌样表型。横纹肌样细胞甲状腺转录因子 - 1、波形蛋白、上皮膜抗原免疫阳性,细胞角蛋白局灶阳性。突触素、嗜铬粒蛋白、甲状腺球蛋白、癌胚抗原、平滑肌肌动蛋白、肌细胞生成素和结蛋白均为阴性。据我们所知,这是第9例甲状腺癌伴有横纹肌样表型的病例报告。与先前报道的病例不同,该病例具有某些不寻常的特征,包括发病于年轻男性、缺乏滤泡/乳头分化以及横纹肌样细胞的免疫组化特征。

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