Gupta Amita Jain, Singh Meeta, Rani Poonam, Khurana Nita, Mishra Anurag
Senior Resident, Department of Pathology, Maulana Azad Medical College , Delhi, India .
Assistant Professor, Department of Pathology, Maulana Azad Medical College , Delhi, India .
J Clin Diagn Res. 2017 Feb;11(2):ER01-ER04. doi: 10.7860/JCDR/2017/22907.9164. Epub 2017 Feb 1.
Primary Malignant Fibrous Histiocytoma (MFH-T) and Leiomyosarcoma (LMS-T) of the thyroid gland are extremely rare tumors. Very few cases have been reported in the literature. Both entities occur more commonly in women than men. The closest clinical and histological differential diagnosis is anaplastic carcinoma of thyroid. We present three cases of rare primary sarcomas of thyroid gland. Case-1 was a 63-year-old woman and Case-2 was a 52-year-old woman. Both of them presented with a rapidly increasing thyroid mass clinically mimicking anaplastic carcinoma (AC-T). Both the patients developed pulmonary metastasis and succumbed to the illness soon after the diagnosis of MFH-T was made. Case 3 was 65-year-old woman with neck swelling since six months diagnosed as LMS-T. The present communication adds three new cases to the literature on sarcomas of thyroid gland with an emphasis on differential diagnosis of spindle cell lesions of thyroid. MFH-T and LMS-T needs to be differentiated from AC-T, metastatic sarcomas, spindle cell variant of medullary carcinoma, synovial sarcoma, fibrosarcoma; final diagnosis rests on histopathology and immunohistochemistry.
甲状腺原发性恶性纤维组织细胞瘤（MFH-T）和平滑肌肉瘤（LMS-T）极为罕见。文献报道的病例极少。这两种肿瘤在女性中的发生率均高于男性。最相近的临床和组织学鉴别诊断是甲状腺未分化癌。我们报告三例罕见的甲状腺原发性肉瘤病例。病例1为一名63岁女性，病例2为一名52岁女性。她们临床上均表现为甲状腺肿物迅速增大，酷似未分化癌（AC-T）。两名患者均发生肺转移，在诊断为MFH-T后不久均因病死亡。病例3是一名65岁女性，颈部肿胀6个月，诊断为LMS-T。本报告为甲状腺肉瘤文献增添了三例新病例，重点在于甲状腺梭形细胞病变的鉴别诊断。MFH-T和LMS-T需要与AC-T、转移性肉瘤、髓样癌梭形细胞变异型、滑膜肉瘤、纤维肉瘤相鉴别；最终诊断依赖于组织病理学和免疫组织化学。
