Gabsi Azza, El Amine El Hadj Olfa, Goucha Aida, Said Gritli, Laabidi Besma, Gamoudi Amor
Tunis Med. 2017 Feb;95(2):97-102.
Medullary thyroid carcinoma is a rare tumor accounting for less than 10% of thyroid neoplasm. This tumor is characterized by important histological polymorphism which makes morphological diagnosis difficult and immunohistochemical study often necessary.
We aim to perform a retrospective review of clinical and pathological characteristics of medullary carcinoma. We will discuss the place of immunohistochemistry in the positive diagnosis and as a prognostic factor.
patients with thyroid medullary carcinoma diagnosed in department of pathology at carcinologic institute between 1998 and 2013 were retrospectively included. Clinic, radiologic and prognostic variables were assessed. Slides were reviewed for all the patients with confirmed tumors.
Twenty-seven patients with CMT were identified. The average age was 55 years with predominance of males. The average consultation time was 16 months. The most common presentation symptom was a cervical lymph node. Total thyroidectomy was performed in 23 patients. Tumor was nodular and unique in 22 cases. The average size was 2.1 cm. CMT was of mixed type containing both medullary and papillary compound in four cases. Amyloid substance was present and abundant in 21cases. Positive staining for calcitonin was observed in 16 cases. Distant metastasis or metastatic lymph nodes was observed in eight cases with an average period of 42 months. Radiotherapy was performed in fifteen cases and two patients received chemotherapy.
In the absence of amyloid deposits, immunohistochemical staining with calcitonin is useful to confirm the diagnosis. The prognosis of this entity is more pejorative than papillary thyroid carcinoma.
甲状腺髓样癌是一种罕见肿瘤，占甲状腺肿瘤的比例不到10%。该肿瘤具有重要的组织学多态性，这使得形态学诊断困难，免疫组化研究常常是必要的。
我们旨在对髓样癌的临床和病理特征进行回顾性研究。我们将讨论免疫组化在阳性诊断及作为预后因素方面的作用。
回顾性纳入1998年至2013年在肿瘤研究所病理科诊断为甲状腺髓样癌的患者。评估临床、放射学和预后变量。对所有确诊肿瘤的患者的切片进行复查。
共确定27例甲状腺髓样癌患者。平均年龄为55岁，男性居多。平均就诊时间为16个月。最常见的症状是颈部淋巴结肿大。23例患者接受了全甲状腺切除术。22例肿瘤为结节状且为单发。平均大小为2.1厘米。4例甲状腺髓样癌为混合型，同时含有髓样和乳头状成分。21例有淀粉样物质且含量丰富。16例降钙素染色阳性。8例出现远处转移或转移性淋巴结，平均时间为42个月。15例患者接受了放疗，2例患者接受了化疗。
在没有淀粉样沉积物的情况下，降钙素免疫组化染色有助于确诊。该实体的预后比甲状腺乳头状癌更差。
