Wei Jianguo, Yang Jianfeng, Liang Wenqing, Xu Chunwei, Wen Yuanyuan
Department of Pathology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, Zhejiang 312000, P.R. China.
Department of Radiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, Zhejiang 312000, P.R. China.
Oncol Lett. 2019 Jan;17(1):281-287. doi: 10.3892/ol.2018.9609. Epub 2018 Oct 23.
Primary thyroid leiomyosarcoma (LMS) is a rare tumor type with an unusual location, the diagnosis is based entirely on histological and immunohistochemical evaluations. In the present study, a rare case of a 74-year-old female patient who exhibited a right anterior neck mass for 12 months, which rapidly enlarged for the last 3 months. Ultrasound of the thyroid revealed a 55×42 mm hypoechoic mass with clear margins in the right lobe. Histological examination of the tumor demonstrated malignant spindle cells in interlacing fascicles and whorls. Additionally, nuclear pleomorphism, tumor giant cells, necrosis and abnormal mitotic figures were observed. The immunohistochemistry indicated that the tumor cells were strongly positive for smooth muscle actin, desmin, p53 and vimentin expression, but negative for cytokeratin, epithelial membrane antigen, thyroid transcription factor-1, paired box-8, 34βE12, cytokeratin 5/6, cluster of differentiation (CD)117, myoglobin, S100, p16. The final histopathological diagnosis was primary thyroid LMS.
原发性甲状腺平滑肌肉瘤（LMS）是一种罕见的肿瘤类型，其位置特殊，诊断完全基于组织学和免疫组织化学评估。在本研究中，有一例罕见病例，一名74岁女性患者，右前颈部肿物已有12个月，在过去3个月迅速增大。甲状腺超声显示右叶有一个55×42mm的低回声肿物，边界清晰。肿瘤组织学检查显示恶性梭形细胞呈交错束状和漩涡状排列。此外，还观察到核多形性、肿瘤巨细胞、坏死及异常有丝分裂象。免疫组织化学显示肿瘤细胞平滑肌肌动蛋白、结蛋白、p53和波形蛋白表达呈强阳性，但细胞角蛋白、上皮膜抗原、甲状腺转录因子-1、配对盒基因8、34βE12、细胞角蛋白5/6、分化簇（CD）117、肌红蛋白、S100、p16呈阴性。最终组织病理学诊断为原发性甲状腺LMS。
