Ljungberg Otto, Nilson Per Olle
Department of Pathology, University of Lund, General Hospital, Malmo, Sweden.
Swedish University of Agricultural Sciences, Uppsala, Sweden.
Endocr Pathol. 1991 Mar;2(1):24-39. doi: 10.1007/BF02915323.
The intermediate type of thyroid carcinoma in humans has been defined as having characteristics of both follicular and parafollicular cell carcinoma. The ultimobranchial (UB) body in mammals is believed to harbor stem cells capable of developing both follicular and parafollicular cells. Hyperplastic and neoplastic lesions of the UB remnants and of the parafollicular cell system frequently occur in bulls. Such lesions, found in 64 individuals (6%) derived from an autopsy material of 1,101 bulls, have been compared structurally and immunohistochemically with 18 human cases of thyroid carcinoma of the intermediate type, in order to define their possible biological relationship. UB changes in bulls formed a continuum ranging from hyperplastic nodules to gross tumors. They contained all epithelial components present in the normal UB remnants in cattle: UB cysts and tubules and solid nests of small basophilic immature cells, which were immunocytochemically indifferent, as wellas mature follicular and neuroendocrine cells. The indifferent cell component dominated in most bull tumors; a minority were mainly formed by mature follicular or parafollicular cells. Human tumors resembled the bull UB tumors structurally and immunohistochemically, although generally the degree of maturation was higher in human tumors. A few were mainly formed by indifferent immature cells and contained typical UB cysts and tubules. One bull tumor and one human tumor contained amyloid. UB changes in bulls were invariably associated with a marked hyperplasia of the parafollicular cell system, in some cases even with tumor development. A similar hyperplasia, but without neoplastic change, was found in 4 of 11 human cases in which nontumorous thyroid parenchyma was available for examination.The findings suggest that intermediate thyroid carcinoma rather than medullary carcinoma is the human equivalent to the bull UB tumors. It is concluded that although both the medullary and the intermediate type of carcinoma appear to be histogenetically related to the UB body, the former shows evidence of a pure parafollicular cell differentiation, whereas the latter develops both follicular and parafollicular, as well as intermediate, cell forms and sometimes also immature structures of the type seen in UB remnants of the adult human thyroid gland.
人类甲状腺癌的中间型已被定义为具有滤泡状和滤泡旁细胞癌的特征。哺乳动物的最后鳃体（UB）被认为含有能够发育为滤泡状和滤泡旁细胞的干细胞。UB残余物和滤泡旁细胞系统的增生性和肿瘤性病变在公牛中经常出现。在1101头公牛的尸检材料中发现了64例（6%）此类病变，并将其与18例人类中间型甲状腺癌病例进行了结构和免疫组织化学比较，以确定它们可能的生物学关系。公牛的UB变化形成了一个连续体，从增生性结节到肉眼可见的肿瘤。它们包含了牛正常UB残余物中存在的所有上皮成分：UB囊肿、小管以及小嗜碱性未成熟细胞的实性巢团，这些细胞在免疫细胞化学上无特异性，还有成熟的滤泡状细胞和神经内分泌细胞。在大多数公牛肿瘤中，无特异性细胞成分占主导；少数主要由成熟的滤泡状或滤泡旁细胞组成。人类肿瘤在结构和免疫组织化学上与公牛的UB肿瘤相似，尽管一般来说人类肿瘤的成熟程度更高。少数主要由无特异性未成熟细胞组成，并含有典型的UB囊肿和小管。1例公牛肿瘤和1例人类肿瘤含有淀粉样物质。公牛的UB变化总是与滤泡旁细胞系统的明显增生相关，在某些情况下甚至与肿瘤发展相关。在11例有非肿瘤性甲状腺实质可供检查的人类病例中，有4例发现了类似的增生，但无肿瘤性改变。研究结果表明，中间型甲状腺癌而非髓样癌相当于人类的公牛UB肿瘤。得出的结论是，尽管髓样癌和中间型癌在组织发生上似乎都与最后鳃体有关，但前者显示出纯粹的滤泡旁细胞分化证据，而后者则发育出滤泡状、滤泡旁以及中间型细胞形式，有时还会出现成人甲状腺UB残余物中所见的未成熟结构。
