Mills S E, Stallings R G, Austin M B
Am J Clin Pathol. 1986 Nov;86(5):674-8. doi: 10.1093/ajcp/86.5.674.
A 79-year-old man with a 28-year history of a substernal goiter had an anaplastic thyroid neoplasm with prominent angiomatoid features develop. Based on the light microscopic appearance of the tumor and the presence of immunocytochemical staining for Factor VIII-related antigen, a diagnosis of angiosarcoma was made. Subsequent immunocytochemical and ultrastructural studies suggested follicular and medullary differentiation without staining for Ulex europeaus I lectin or evidence of Weibel-Palade bodies. Based on these findings, the tumor is interpreted as an anaplastic carcinoma with evidence of mixed follicular and medullary differentiation and extensive intravascular growth producing an angiomatoid appearance. Positivity for Factor VII-related antigen may be due to nonspecific uptake of antigen-rich serum and platelets by the phagocytic tumor cells. Factor VIII-related antigen immunoreactivity should be interpreted with caution in intravascular neoplasms.
一名患有胸骨后甲状腺肿28年的79岁男性发生了具有显著血管肉瘤样特征的间变性甲状腺肿瘤。根据肿瘤的光镜表现以及VIII因子相关抗原的免疫细胞化学染色结果，诊断为血管肉瘤。随后的免疫细胞化学和超微结构研究提示有滤泡和髓样分化，但欧洲荆豆I凝集素染色阴性且无魏贝尔-帕拉德小体证据。基于这些发现，该肿瘤被解释为具有混合滤泡和髓样分化证据且广泛血管内生长形成血管肉瘤样外观的间变性癌。VII因子相关抗原阳性可能是由于吞噬性肿瘤细胞非特异性摄取富含抗原的血清和血小板所致。在血管内肿瘤中，VIII因子相关抗原免疫反应性的解读应谨慎。
