Sun Yan-Hua, Xu Juan, Li Ming
Department of Pathology, Shenzhen Second People's Hospital, Sun Yat-sen University Shenzhen, Guangdong Province, PR China.
Department of Pharmacology and Proteomics Center, Zhongshan School of Medicine, Sun Yat-sen University Guangzhou, Guangdong Province, PR China.
Int J Clin Exp Pathol. 2018 Oct 1;11(10):5139-5143. eCollection 2018.
Intrathyroid thymic carcinoma (ITCA) is a rare neoplasm of the thyroid gland, that is difficult to diagnose because of its complex pathologic and immunohistochemical characteristics. Here, we report two cases that may provide a better understanding of this disease. Case 1 is a 30-year-old man, and Case 2 is a 42-year-old man. The two cases showed an irregular solid thyroid mass on sonography. Histological examination revealed the solid growth of epithelial cells separated by bands of dense, hyalinized, and fibrous stroma. Tumor cells were positive for the expression of CD5, HMWK, CK19, CK5/6, CK7, EMA, CD117, p63, Bcl-2, and NANOG. It is noteworthy that the neuroendocrine markers Syn, NSE, and CgA were also observed. In Case 1, chemotherapy combined with radiotherapy, chest CT showed lung metastasis 4 months after resection. The patient was alive as of postoperative follow up lasting 46 months. Radical operation combined with radiotherapy was performed in case 2, and the patient was alive as of follow-up lasting 42 months.
甲状腺内胸腺癌（ITCA）是一种罕见的甲状腺肿瘤，因其复杂的病理和免疫组化特征而难以诊断。在此，我们报告两例病例，可能有助于更好地了解这种疾病。病例1为一名30岁男性，病例2为一名42岁男性。两例病例超声检查均显示甲状腺有不规则实性肿块。组织学检查显示上皮细胞呈实性生长，被致密、玻璃样变和纤维性间质带分隔。肿瘤细胞CD5、高分子量角蛋白（HMWK）、细胞角蛋白19（CK19）、细胞角蛋白5/6（CK5/6）、细胞角蛋白7（CK7）、上皮膜抗原（EMA）、CD117、p63、Bcl-2和NANOG表达均为阳性。值得注意的是，还观察到神经内分泌标志物突触素（Syn）、神经元特异性烯醇化酶（NSE）和嗜铬粒蛋白A（CgA）。病例1采用化疗联合放疗，切除术后4个月胸部CT显示肺转移。截至术后46个月的随访，患者仍存活。病例2行根治性手术联合放疗，截至42个月的随访，患者仍存活。
