Mizukami Y, Nonomura A, Michigishi T, Noguchi M, Ishizaki T
Pathology Section, Kanazawa University Hospital, Japan.
Pathol Res Pract. 1996 Jan;192(1):67-71; discussion 72-4. doi: 10.1016/S0344-0338(96)80134-8.
We describe an unusual case of a thyroid carcinoma exhibiting glandular and sarcomatous features. The tumor occurred in a 16-year-old girl. Histologic study of the resected thyroid gland revealed an encapsulated tumor composed predominantly of glandular structures and some solid areas. In the glandular areas, the tumor cells showed a cribriform growth pattern, and neither colloid secretion into the lumen nor clear-cut cytologic features suggestive of papillary or follicular thyroid carcinoma were observed. In the solid areas, tumor cells became spindled and showed a sarcomatous arrangement with occasional whorl formation. A transition from the glandular areas to the solid ones was observed. Immunohistochemical study revealed that tumor cells were positive focally for epithelial membrane antigen, cytokeratin and secretory component. Thyroglobulin was positive only in a few and limited areas of the glandular component. Calcitonin was negative throughout the tumor. The histologic and immunohistochemical evidence indicates that this tumor is of thyroid origin and is probably derived from thyroid follicular cells. The histology of this tumor is unique, so we report this case briefly.
我们描述了一例表现出腺性和肉瘤样特征的甲状腺癌罕见病例。该肿瘤发生在一名16岁女孩身上。对切除的甲状腺进行组织学研究发现，肿瘤有包膜，主要由腺性结构和一些实性区域组成。在腺性区域，肿瘤细胞呈筛状生长模式，未观察到向管腔内分泌胶体，也未观察到提示乳头状或滤泡状甲状腺癌的明确细胞学特征。在实性区域，肿瘤细胞呈梭形，表现出肉瘤样排列，偶尔有漩涡状形成。观察到从腺性区域到实性区域的过渡。免疫组织化学研究显示，肿瘤细胞在上皮膜抗原、细胞角蛋白和分泌成分方面呈局灶性阳性。甲状腺球蛋白仅在腺性成分的少数有限区域呈阳性。降钙素在整个肿瘤中均为阴性。组织学和免疫组织化学证据表明，该肿瘤起源于甲状腺，可能来源于甲状腺滤泡细胞。该肿瘤的组织学表现独特，因此我们简要报告此病例。
