Osakabe Mitsumasa, Fukagawa Tomoyuki, Fukagawa Daisuke, Sugimoto Ryo, Uesugi Noriyuki, Ishida Kazuyuki, Itamochi Hiroaki, Sugiyama Toru, Sugai Tamotsu
Department of Molecular Diagnostic Pathology, School of Medicine, Iwate Medical University 19-1, Morioka 020-8505, Iwate, Japan.
Department of Obstetrics and Gynecology, School of Medicine, Iwate Medical University 19-1, Morioka 020-8505, Iwate, Japan.
Int J Clin Exp Pathol. 2017 Nov 1;10(11):11230-11233. eCollection 2017.
We present a case of struma ovarii with unique histological features. A 57-year-old woman presented with a 13-cm multilocular cystic ovarian tumor. Histological examination demonstrated both differentiated (follicular patterns) and de-differentiated (diffuse, trabecular and small-sized solid nests) patterns, suggesting a histological diagnosis of struma ovarii. To identify the pathogenesis of the tumor, immunohistochemical (TTF1, thyroglobulin, T3, E-cadherin, ZEB1, Slug, and Twist) and genetic ( and ) analyses were performed. TTF1, thyroglobulin, and T3 were detected in both tumor components. Additionally, although E-cadherin was detected in the differentiated component, loss of E-cadherin was obvious in the de-differentiated component. Finally, we examined ZEB1, Slug, and Twist expression to identify the role of epithelial-mesenchymal transition (EMT) in tumor pathogenesis. Slug, ZEB1, and Twist were not expressed in the differentiated component, but ZEB1 expression was observed in the de-differentiated component. Moreover, no or mutations were detected in either component. These findings suggested that the histological transition from the differentiated to de-differentiated tissue was closely associated with the loss of E-cadherin expression. This loss may have been related to increased ZEB1 expression and lack of neoplastic features due to the absence of and mutations.
我们报告一例具有独特组织学特征的卵巢甲状腺肿。一名57岁女性因一个13厘米的多房性囊性卵巢肿瘤就诊。组织学检查显示既有分化型（滤泡样模式）又有去分化型（弥漫性、小梁状和小尺寸实性巢状）模式，提示卵巢甲状腺肿的组织学诊断。为了确定肿瘤的发病机制，进行了免疫组化（TTF1、甲状腺球蛋白、T3、E-钙黏蛋白、ZEB1、Slug和Twist）和基因（ 和 ）分析。在肿瘤的两个成分中均检测到TTF1、甲状腺球蛋白和T3。此外，虽然在分化成分中检测到E-钙黏蛋白，但在去分化成分中E-钙黏蛋白的缺失很明显。最后，我们检测了ZEB1、Slug和Twist的表达，以确定上皮-间质转化（EMT）在肿瘤发病机制中的作用。Slug、ZEB1和Twist在分化成分中未表达，但在去分化成分中观察到ZEB1表达。此外，在任何一个成分中均未检测到 或 突变。这些发现表明，从分化组织到去分化组织的组织学转变与E-钙黏蛋白表达的缺失密切相关。这种缺失可能与ZEB1表达增加以及由于缺乏 和 突变而缺乏肿瘤特征有关。
