Watanabe I, Tezuka F, Yamaguchi M, Sagawa J, Kaise N
Division of Surgery, Tohoku Teishin Hospital, Sendai, Japan.
Pathol Int. 1996 Jun;46(6):450-6. doi: 10.1111/j.1440-1827.1996.tb03636.x.
A highly malignant case of intrathyroidal thymic carcinoma showing morphological and biochemical evidence identical with mediastinal thymoma is presented. A 32-year-old female, who had previously undergone total colectomy with ileo-proctostomy due to familial adenomatous polypnosis, was operated on for a tumor (3.4 x 4.5 cm) originating from the left thyroid lobe. A minute focus (diam. 0.8 cm) of papillary adenocarcinoma also existed in the upper pole of the right lobe. The main tumor was morphologically an epithelial thymoma with scanty lymphocyte intermixing and showed medullary differentiation with apparent Hassall's corpuscles. Mitosis was frequent and numerous tumor thrombi were in the subcapsular veins. Five months after the total thyroidectomy and lymph node dissection, a subcutaneous recurrence of the tumour (diam. 2.3 cm) appeared in the anterior cervical region. The cystic contents of the recurrent tumor revealed a high titer of thymosin alpha 1-Other organs, including thymus, lungs, and adrenals, had all been free of neoplastic changes clinically and radiologically for 5 months after her first admission until the local tumor recurrence.
本文报告1例高度恶性的甲状腺内胸腺癌,其形态学和生化证据与纵隔胸腺瘤相同。一名32岁女性,因家族性腺瘤性息肉病曾接受全结肠切除术及回肠直肠吻合术,此次因起源于左甲状腺叶的肿瘤(3.4×4.5cm)接受手术。右叶上极还存在一个微小的乳头状腺癌灶(直径0.8cm)。主要肿瘤在形态上为上皮性胸腺瘤,淋巴细胞混杂较少,显示髓质分化并有明显的哈氏小体。有丝分裂频繁,包膜下静脉内有大量肿瘤血栓。全甲状腺切除及淋巴结清扫术后5个月,颈部前方区域出现肿瘤皮下复发(直径2.3cm)。复发肿瘤的囊内容物显示胸腺素α1滴度很高。从首次入院到局部肿瘤复发,包括胸腺、肺和肾上腺在内的其他器官在临床上和放射学上5个月均无肿瘤改变。