Oishi Naoki, Kondo Tetsuo, Nakazawa Tadao, Mochizuki Kunio, Kasai Kazunari, Inoue Tomohiro, Yamamoto Takanori, Watanabe Hiroyuki, Hatsushika Kyousuke, Masuyama Keisuke, Katoh Ryohei
Department of Pathology, School of Medicine, University of Yamanashi, Japan.
Department of Pathology, School of Medicine, University of Yamanashi, Japan.
Pathol Res Pract. 2014 Dec;210(12):1142-5. doi: 10.1016/j.prp.2014.04.020. Epub 2014 May 9.
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is an extremely rare neoplasm characterized by morphological analogy to papillary thyroid carcinoma and abnormal expression of thyroid transcription factor-1 (TTF-1). Here we report a novel case of TL-LGNPPA with literature review. The patient was a 43-year-old woman complaining of nasal obstruction. Laryngoscopic study and computed tomography identified a pedunculated mass located on the posterior edge of the left nasal septum. Histologically, the tumor consisted of papillary growth of cuboidal or columnar epithelium. Tubular architecture and a spindle cell component were also observed focally. Some tumor cells exhibited intra-nuclear cytoplasmic inclusions. Immunohistochemically, the neoplastic cells were positive for pancytokeratin (AE1/AE3), CK7, CK19, TTF-1, vimentin and HBME1, but negative for thyroglobulin, Pax8 and CK5/6. Ki67-labeling index reached 5% in the most concentrated spot. Despite the morphological and immunohistochemical similarity to papillary thyroid carcinoma, no BRAF V600E mutation was detected by mutation-specific immunohistochemistry. The patient had neither local recurrence nor distant metastasis 19 months after removal of the tumor.
甲状腺样低级别鼻咽乳头状腺癌（TL-LGNPPA）是一种极其罕见的肿瘤，其特征是在形态上类似于乳头状甲状腺癌，且甲状腺转录因子-1（TTF-1）表达异常。在此，我们报告一例TL-LGNPPA新病例并进行文献复习。患者为一名43岁女性，主诉鼻塞。喉镜检查和计算机断层扫描发现左侧鼻中隔后缘有一有蒂肿物。组织学上，肿瘤由立方上皮或柱状上皮的乳头状生长构成。局部还可见管状结构和梭形细胞成分。部分肿瘤细胞可见核内胞质包涵体。免疫组化显示，肿瘤细胞广谱细胞角蛋白（AE1/AE3）、CK7、CK19、TTF-1、波形蛋白和HBME1呈阳性，但甲状腺球蛋白、Pax8和CK5/6呈阴性。Ki67标记指数在最密集处达5%。尽管在形态和免疫组化上与乳头状甲状腺癌相似，但通过突变特异性免疫组化未检测到BRAF V600E突变。肿瘤切除19个月后，患者既无局部复发也无远处转移。
