Kinoshita Yuichi, Takasu Kosho, Yuri Takashi, Yoshizawa Kastuhiko, Emoto Yuko, Tsubura Airo, Shikata Nobuaki
Department of Pathology II, Kansai Medical University, Amagasaki, Japan ; Division of Diagnostic Cytopathology and Histopathology, Kansai Medical University Takii Hospital, Moriguchi, Amagasaki, Japan.
Case Rep Oncol. 2013 Apr 6;6(1):216-23. doi: 10.1159/000350784. Print 2013 Jan.
The diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) is a relatively rare tumor. We herein report the case of young woman with DSV-PTC who developed cervical lymph node recurrence 7 years after the initial surgery. A 15-year-old female patient with no medical or family history of thyroid tumors developed a thyroid neoplasm in the right lobe. Right thyroidectomy and regional lymphadenectomy were performed, and the tumor was diagnosed as DSV-PTC. She was followed up as an outpatient. Seven years after the surgery, cervical lymph node recurrence developed. On microscopic examination, the thyroid tumor showed a papillary growth pattern with numerous psammoma bodies and distinct fibrosis. Immunohistochemically, the tumor cells were estrogen receptor and progesterone receptor positive with reduced membranous expression of E-cadherin and were intermingled with S-100-positive dendritic/Langerhans cells. DSV-PTC is characterized by a strong tendency for invasion and metastasis. Thus, accurate diagnosis is clinically important, and a morphological and immunohistochemical understanding of DSV-PTC is necessary.
甲状腺乳头状癌弥漫硬化型（DSV-PTC）是一种相对罕见的肿瘤。我们在此报告一例患有DSV-PTC的年轻女性病例，该患者在初次手术后7年出现颈部淋巴结复发。一名15岁女性患者，无甲状腺肿瘤的个人或家族病史，其右叶出现甲状腺肿瘤。行右侧甲状腺切除术及区域淋巴结清扫术，肿瘤被诊断为DSV-PTC。她作为门诊患者接受随访。手术后7年，出现颈部淋巴结复发。显微镜检查显示，甲状腺肿瘤呈乳头状生长模式，有大量砂粒体和明显纤维化。免疫组化显示，肿瘤细胞雌激素受体和孕激素受体阳性，E-钙黏蛋白膜表达减少，并与S-100阳性树突状/朗格汉斯细胞混合。DSV-PTC的特点是具有很强的侵袭和转移倾向。因此，准确诊断在临床上很重要，对DSV-PTC进行形态学和免疫组化了解是必要的。
