摘要/Abstract
摘要： 目的 ·探讨甲状腺内胸腺癌的临床病理特征。方法 ·回顾性分析 5例甲状腺内胸腺癌患者的临床病例资料。对手术切除的肿瘤组织行组织学观察及免疫组织化学染色，采用 EB病毒（ EBV）编码小 RNA（EBV-encoded RNA，EBER）原位杂交方法检测 EBV感染情况，采用突变扩增阻滞系统方法检测 BRAF基因 V600E突变。结果 · 5例患者中，男性 3例，女性 2例，年龄 51～ 69岁，平均年龄 60.8岁。肿瘤均位于甲状腺内，最大直径 2.0～ 3.5 cm。肿瘤在蛋白水平表达广谱型细胞角蛋白（ CK）、细胞角蛋白 19（CK19）、抑癌基因 P40蛋白（ P40）、白细胞分化抗原 5（CD5）、白细胞分化抗原 117（CD117）、B细胞淋巴瘤因子 2（Bcl-2）、细胞增殖核抗原（ Ki67），其他相关肿瘤鉴别诊断标志物高分子量细胞角蛋白（ 34βE12）、甲状腺过氧化物酶（ TPO）、甲状腺球蛋白（ TG）、甲状腺转录因子 1（TTF1）、突触素（ SYN）、EBV、鼠类肉瘤滤过性毒菌致癌同源体 B1蛋白（ BRAF）均呈阴性。 EBER原位杂交结果为阴性，且无 BRAF 基因 V600E突变。结论 ·甲状腺内胸腺癌是一种惰性肿瘤，非常少见；肿瘤细胞表达 CD5、CD117，具有重要的鉴别诊断意义。
关键词: 甲状腺内胸腺癌, 免疫表型, 临床病理
Abstract:
Objective · To investigate the clinicopathological features of intrathyroid thymic carcinoma. Methods · Clinical data of 5 patients with intrathyroid thymic carcinoma were retrospectively reviewed. Histological examination and immunohistochemical staining were performed on the surgically resected tumors. The infection of EB virus (EBV) was detectedin situ hybridization of EBV-encoded RNAs (EBER). BRAF V600E mutation was examinedamplification refractory mutation system. Results · There were 3 males and 2 females with age between 51 and 69 years (average of 60.8 years). All 5 cases were intrathyroid tumors. The tumors were 2.0-3.5 cm in diameter. All 5 cases showed positive staining for CK, CK19, P40, CD5, CD117, Bcl-2, and Ki-67 at protein level, and negative staining for other related differential diagnosis markers including 34βE12, TPO, TG, TTF1, SYN, EBV, and BRAF. In situ hybridization of EBER showed negative results and no BRAF V600E mutation was found. Conclusion · Intrathyroid thymic carcinoma is a low-grade malignant tumor. Expressions of CD5 and CD117 in tumor cells play a very important role in the differential diagnosis.
Key words: intrathyroid thymic carcinoma, immunophenotype, clinical pathology
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