Sakamoto Reid I, Sumida Lauren C, Lum Christopher A K, Tauchi-Nishi Pamela S
Department of Pathology, The Queen's Medical Center, Honolulu, HI (RIS, CAKL, PST-N).
Hawaii J Med Public Health. 2015 Feb;74(2):51-6.
Papillary thyroid carcinoma (PTC) is typically an indolent disease characterized by slow growth and a favorable prognosis. In rare instances, this disease may metastasize to the pleura and manifest as a malignant pleural effusion. We report 3 female patients of Japanese/Okinawan ancestry with a history of PTC who presented with hydrothorax. Cytologic examination in conjunction with immunohistochemical staining enabled a definitive diagnosis of metastatic PTC. Molecular analysis of the mitogen activated protein kinase (MAPK) and phosphatidylinositol 3-kinase (PI3K) pathways demonstrated the presence of the v-raf murine sarcoma viral oncogene homolog B (BRAF)(V600E) mutation in 2 of our 3 patients, with the absence of any other clinically significant mutations in all cases. Further investigation is necessary to elucidate the molecular and environmental mechanisms involved in this aggressive manifestation of PTC.
甲状腺乳头状癌（PTC）通常是一种生长缓慢、预后良好的惰性疾病。在罕见情况下，这种疾病可能转移至胸膜并表现为恶性胸腔积液。我们报告了3名具有日本/冲绳血统且有PTC病史的女性患者，她们表现为胸腔积液。细胞学检查结合免疫组化染色得以明确诊断转移性PTC。对丝裂原活化蛋白激酶（MAPK）和磷脂酰肌醇3激酶（PI3K）途径的分子分析显示，我们的3例患者中有2例存在v-raf鼠肉瘤病毒癌基因同源物B（BRAF）（V600E）突变，所有病例均未发现任何其他具有临床意义的突变。有必要进一步研究以阐明PTC这种侵袭性表现所涉及的分子和环境机制。
