Amico Paolo, Lanzafame Salvatore, Li Destri Giovanni, Greco Paolo, Caltabiano Rosario, Vecchio Giada Maria, Magro Gaetano
Section of Anatomic Pathology, Department G.F. Ingrassia, University of Catania, 95123 Catania, Italy.
Case Rep Med. 2010;2010:495281. doi: 10.1155/2010/495281. Epub 2010 Jun 7.
Warthin tumor-like papillary thyroid carcinoma is an uncommon variant of papillary thyroid carcinoma. We report a rare case of Warthin tumor-like variant of papillary thyroid carcinoma with a dedifferentiated component consisting of a solid tumor area composed of neoplastic cells with a spindle to tall cell morphology associated with marked nuclear pleomorphism, atypical mitoses, and foci of necrosis. Although our patient presented with a locally aggressive disease (T3 N1b Mo), she is disease-free without radioiodine therapy after a 23-month follow-up period. We emphasize that Warthin tumor-like papillary thyroid carcinoma, like other morphological variants of papillary carcinoma, may occasionally undergo dedifferentiation. As this component may be only focally detectable, we suggest an extensive sampling of all large-sized (>3 cm) papillary thyroid carcinoma. Recognition of any dedifferentiated component in a Warthin tumor-like papillary thyroid carcinoma should be reported, including its percentage, because it may reflect a more aggressive clinical course.
沃辛瘤样乳头状甲状腺癌是乳头状甲状腺癌的一种罕见变异型。我们报告了一例罕见的沃辛瘤样乳头状甲状腺癌变异型病例，其具有去分化成分，该成分由一个实性肿瘤区域组成，该区域由具有梭形至高细胞形态的肿瘤细胞构成，伴有明显的核多形性、非典型有丝分裂和坏死灶。尽管我们的患者表现为局部侵袭性疾病（T3 N1b Mo），但在23个月的随访期后，她未经放射性碘治疗，目前无疾病。我们强调，沃辛瘤样乳头状甲状腺癌与乳头状癌的其他形态学变异型一样，偶尔可能会发生去分化。由于该成分可能仅在局部可检测到，我们建议对所有大尺寸（>3 cm）的乳头状甲状腺癌进行广泛取材。应报告沃辛瘤样乳头状甲状腺癌中任何去分化成分，包括其百分比，因为这可能反映出更具侵袭性的临床病程。
