Carcangiu M L, Steeper T, Zampi G, Rosai J
Am J Clin Pathol. 1985 Feb;83(2):135-58. doi: 10.1093/ajcp/83.2.135.
Seventy cases of anaplastic thyroid carcinomas studied at the Universities of Florence (Italy) and Minnesota are presented. Three morphologic patterns were seen: spindle, giant cell, and squamoid, sometimes in combination. Ultrastructurally, evidence of epithelial differentiation was seen in most but not all cases studied. Immunohistochemically, a stain for cytokeratin using a monoclonal antibody was found the most useful adjunct to diagnosis. Unexpected positivity for carcinoembryonic antigen (CEA) was found in several squamoid tumors. The alleged frequent positivity of this tumor type for thyroglobulin and calcitonin was not confirmed. A third of the tumors were associated with a better differentiated component, of which, presumably, they represented a dedifferentiation. The extremely aggressive behavior of anaplastic thyroid carcinomas was confirmed amply in this series: all of the patients in whom follow-up information was available died of their tumor. Small cell tumors should not be included into the anaplastic category, since they invariably belong to other groups, i.e., malignant lymphoma, medullary carcinoma, and poorly differentiated ("insular") carcinoma.
本文报告了在意大利佛罗伦萨大学和明尼苏达大学研究的70例间变性甲状腺癌。观察到三种形态学模式：梭形、巨细胞和鳞状，有时会混合出现。在超微结构上，大多数（但并非所有）研究病例中可见上皮分化的证据。免疫组织化学方面，发现使用单克隆抗体对细胞角蛋白进行染色是诊断最有用的辅助手段。在一些鳞状肿瘤中发现癌胚抗原（CEA）意外呈阳性。这种肿瘤类型据称对甲状腺球蛋白和降钙素的频繁阳性并未得到证实。三分之一的肿瘤与分化较好的成分相关，推测它们代表了一种去分化。在本系列中充分证实了间变性甲状腺癌的极具侵袭性的行为：所有有随访信息的患者均死于肿瘤。小细胞肿瘤不应归入间变性类别，因为它们总是属于其他组，即恶性淋巴瘤、髓样癌和低分化（“岛状”）癌。
