Chetty R, Clark S P, Dowling J P
Department of Anatomical Pathology, Royal Melbourne Hospital, Victoria.
Pathology. 1993 Apr;25(2):203-5. doi: 10.3109/00313029309084801.
A primary leiomyosarcoma of the thyroid was seen in a 54 yr old female. The patient had a solitary, cold nodule with no abnormalities of thyroid function tests. Histologically it was composed of characteristic interlacing fascicles of spindle cells which, electron microscopically, showed thin myofilaments with focal dense bodies. Immunohistochemistry showed a strong reaction with vimentin, smooth muscle actin and desmin. No epithelial differentiation was noted immunohistochemically or ultrastructurally. No tumor recurrence was detected 15 mths after surgery. It is postulated that the smooth muscle differentiation had arisen by metaplastic change or de-differentiation with re-differentiation of anaplastic thyroid carcinoma.
一名54岁女性被诊断为原发性甲状腺平滑肌肉瘤。患者有一个孤立的冷结节，甲状腺功能测试无异常。组织学上，它由特征性的梭形细胞交织束组成，电子显微镜下显示有细肌丝和局灶性致密小体。免疫组织化学显示波形蛋白、平滑肌肌动蛋白和结蛋白呈强阳性反应。免疫组织化学和超微结构均未发现上皮分化。术后15个月未检测到肿瘤复发。推测平滑肌分化是由化生改变或间变性甲状腺癌去分化并重新分化引起的。
