Li H, Li H X, Zhu Y, Zhang Z H, Fan Q H
Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Zhonghua Bing Li Xue Za Zhi. 2016 Jun 8;45(6):364-7. doi: 10.3760/cma.j.issn.0529-5807.2016.06.002.
To investigate the clinicopathologic characteristics of primary angiosarcoma in thyroid.
Three cases of primary angiosarcoma in thyoid were analyzed by gross examination, light microscopy and immunohistochemical staining, as well as related literatures were reviewed.
The patients included 2 males and 1 female. The age of patients ranged from 52 to 78 years. The tumors showed an infiltrating histological pattern. Irregular, anastomosing gaping vascular channels were usually evident, and intravascular papillary fronds were occasionally present. In other areas, tumors featured a solid pattern of growth with cells arranged in sheets and nests with no intervening stroma. The neoplastic cells were epithelioid, spindled or polygonal-shaped with abundant eosinophilic cytoplasm and round, large, vesicular nuclei containing prominent nucleoli. The tumors showed brisk mitotic activity and necrosis. Immunohistochemical study revealed that the tumor cells were positive for CD31, ERG, Fli1, CD34, FⅧRAg and CKpan to different extents.
Primary epithelioid angiosarcoma of the thyroid is a rare, high-grade malignancy that may be misdiagnosed as other malignancies, especially anaplastic thyroid carcinoma. Recognizing its clinicopathologic characters and combined application of specific vascular endothelial immunohistochemical markers is important to avoid confusion with other lesions.
探讨甲状腺原发性血管肉瘤的临床病理特征。
对3例甲状腺原发性血管肉瘤进行大体检查、光镜检查及免疫组化染色分析，并复习相关文献。
患者包括2例男性和1例女性。患者年龄52至78岁。肿瘤呈浸润性组织学模式。通常可见不规则、相互吻合的扩张血管腔隙，偶尔可见血管内乳头状突起。在其他区域，肿瘤呈实性生长模式，细胞排列成片和巢状，无间质。肿瘤细胞呈上皮样、梭形或多边形，胞质丰富嗜酸性，核圆形、大、泡状，核仁明显。肿瘤有活跃的有丝分裂象和坏死。免疫组化研究显示肿瘤细胞不同程度地表达CD31、ERG、Fli1、CD34、FⅧRAg和CKpan。
甲状腺原发性上皮样血管肉瘤是一种罕见的高级别恶性肿瘤，可能被误诊为其他恶性肿瘤，尤其是未分化甲状腺癌。认识其临床病理特征并联合应用特异性血管内皮免疫组化标记物对于避免与其他病变混淆很重要。
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