摘要
目的 :探讨甲状腺上皮样血管肉瘤的临床病理学特征。方法 :对 2例原发于甲状腺的上皮样血管肉瘤进行光镜观察和免疫组化标记。结果 :2例均为老年患者 ,以颈部包块就诊 ,其中 1例伴有地方性甲状腺肿。镜下显示 ,肿瘤主要由实性片状或巢状排列的上皮样细胞组成 ,瘤细胞核大 ,空泡状 ,含有明显的核仁 ,部分瘤细胞的胞质内可见含有红细胞的空泡或小管腔形成。除实性区域外 ,可见内衬上皮样瘤细胞的不规则性血管腔 ,网状纤维染色能清晰显示这些管腔结构 ,特别是在HE染色下管腔结构不甚明显的实性区域内。免疫组化标记显示瘤细胞表达CD31、CD34、FⅧRAg、BNH9、UEA 1和AE1 /AE3 ,不表达CK8和Tg。结论 :原发于甲状腺的上皮样血管肉瘤具有一定的临床病理学特点 ,光镜形态、免疫组化标记及电镜观察均支持瘤细胞具内皮细胞分化 ,应被视为甲状腺肿瘤中一种独立的病理学类型 。
Purpose To study the clinical and pathological features of epithelioid angiosarcoma of thyroid. Method Two cases of primary epithelioid angiosarcoma of the thyroid were investigated by light microscopy and immunohistochemistry. Results Both cases occurred in the elders and presented as gradually enlarging thyroid masses. One of the patient was accompanied by a long standing nodular goiter. Microscopically, the tumor consisted predominantly of solid sheets or nests of large epithelioid cells with large vesicular nuclei and prominent nucleoli. Intracytoplasmic lumina containing red blood cells were identified. Formation of irregular vascular spaces by the neoplastic cells was also noted in some areas. Reticulin staining highlighted these vascular structures, especially in the solid areas whereas the vascular channels were not prominent with the conventional hematoxylin and eosin staining. Immunohistochemically, the large epithelioid cells stained positively to CD31, CD34, factor Ⅷ related antigen, BNH9, Ulex europaeus I lectin and AE1/AE3. They were negative for cytokeratin 8 and thyroglobulin. Conclusions Primary thyroid epithelioid angiosarcoma is a distinctive entity with characteristic features. It should not be included in the inexplicit category of undifferentiated carcinoma.
出处
《临床与实验病理学杂志》
CAS
CSCD
2002年第5期482-485,共4页
Chinese Journal of Clinical and Experimental Pathology
关键词
甲状腺肿瘤
上皮样血管肉瘤
诊断
thyroid neoplasms
epithelioid angiosarcoma
diagnosis
