Chan J K, Tse C C
Institute of Pathology, Queen Elizabeth Hospital, Hong Kong.
Hum Pathol. 1988 Feb;19(2):195-200. doi: 10.1016/s0046-8177(88)80349-6.
Although textbooks often state that demonstration of mucin in a metastatic carcinoma excludes the possibility of a thyroidal primary tumor, mucin recently has been reported in various types of thyroid carcinoma, particularly medullary carcinoma. The presence of mucin in papillary carcinoma has not been extensively studied, even though this tumor not uncommonly presents with lymph node metastasis. We stained 40 lymph nodes containing metastatic papillary carcinoma of the thyroid for mucin. Mucin was demonstrable by mucicarmine stain in the colloid, luminal borders, and cytoplasm in 18 (45%), 9 (22.5%), and 7 (17.5%) cases respectively; 17 cases (42.5%) were completely negative. With alcian blue staining, mucin was seen in 9 (22.5%), 9 (22.5%), and 7 (17.5%) cases; 25 cases (62.5%) were negative. Most of the cytoplasmic vacuoles were target-like, with a peripheral rim of sulfated acid mucin and a central core of neutral mucin. The psammoma bodies stained consistently with mucicarmine, alcian blue, and periodic acid-Schiff. We conclude that papillary carcinoma of the thyroid should be included in the differential diagnoses for a mucin-producing metastatic carcinoma.
尽管教科书常常指出，在转移性癌中发现黏蛋白可排除甲状腺原发性肿瘤的可能性，但最近有报道称，在各类甲状腺癌中，尤其是髓样癌中发现了黏蛋白。乳头状癌中黏蛋白的存在尚未得到广泛研究，尽管该肿瘤常伴有淋巴结转移。我们对40个含有甲状腺转移性乳头状癌的淋巴结进行了黏蛋白染色。分别有18例（45%）、9例（22.5%）和7例（17.5%）的胶体、管腔边界和细胞质经黏液卡红染色可显示黏蛋白；17例（42.5%）完全为阴性。经阿尔辛蓝染色，分别有9例（22.5%）、9例（22.5%）和7例（17.5%）可见黏蛋白；25例（62.5%）为阴性。大多数细胞质空泡呈靶样，周边为硫酸化酸性黏蛋白，中央为中性黏蛋白核心。砂粒体对黏液卡红、阿尔辛蓝和过碘酸-希夫染色均呈一致染色。我们得出结论，甲状腺乳头状癌应纳入产生黏蛋白的转移性癌的鉴别诊断。
