Papillary thyroid carcinoma with desmoid-type fibromatosis: A clinical, pathological, and immunohistochemical study of 14 cases
Papillary thyroid carcinoma with desmoid-type fibromatosis: A clinical, pathological, and immunohistochemical study of 14 cases
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DOI：
10.1507/endocrj.ej17-0242
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发表时间：
2017-01-01
影响因子：
2
通讯作者：
Miyauchi, Akira
中科院分区：
文献类型：
--
作者：
Takada, Nami;Hirokawa, Mitsuyoshi;Miyauchi, Akira
摘要甲状腺乳头状癌合并韧带样型纤维瘤病是以成纤维细胞的遗传改变为特征。PTC-DTF非常罕见，关于此类病例的报告是零星的。使用β-连环蛋白抗体的免疫组织化学染色可用于诊断该变体。本报告旨在描述14例PTC-DTF的临床、病理和免疫组化表现，并阐明该变异的诊断意义。患者包括9名女性和5名男性，平均年龄为49.3岁。包括局灶性DTF成分和广泛DTF成分的PTC各7例。广泛性DTF和局灶性DTF病例在年龄、性别和血清甲状腺球蛋白水平方面无显著差异。在抽吸细胞学上，12例报告为可疑恶性或恶性，神经鞘瘤或纤维瘤各1例。DTF成分在组织学上可分为4种类型，即中央型（4例）、周围型（1例）、混合型（7例）和弥漫型（2例）。基质成分与DTF一致。免疫组化显示，12例DTF成分中的成纤维细胞在细胞核和细胞质中表达β-连环蛋白。即使在基质成分局灶性存在的情况下，也可以观察到这些特征。Ki-67标记指数> 5%的成纤维细胞和癌细胞均未检出。我们同意PTC伴结节性筋膜炎样间质应更名为PTC DTF。
Papillary thyroid carcinoma (PTC) with desmoid-type fibromatosis (DTF) is characterized by genetic alterations of the fibroblasts. PTC-DTF is extremely rare, and the reports on such cases have been sporadic. Immunohistochemical staining using the antibody for beta-catenin is useful in diagnosing the variant. This report aims to describe the clinical, pathological, and immunohistochemical findings in 14 cases of PTC-DTF and to clarify the diagnostic significance of the variant. The patients included 9 women and 5 men, with a mean age of 49.3 years. PTCs with focal DTF components and with extensive DTF components included 7 cases each. No significant differences were noted in terms of age, gender, and serum thyroglobulin levels between extensive and focal DTF cases. On aspiration cytology, 12 cases were reported as suspicious for malignancy or malignant, and schwannoma or fibroma was suggested in 1 case each. The DTF components were histologically classified into 4 types, namely, central (4 cases), peripheral (1 case), mixed (7 cases), and diffuse type (2 cases). The stromal components were consistent with those of DTF. Immunohistochemically, fibroblasts in the DTF components showed nuclear and cytoplasmic expression for beta-catenin in 12 cases. The features are observed even in cases in which stromal components focally exist. Neither carcinoma cells nor the fibroblasts with Ki-67 labeling index > 5% were found in all cases. We agree that PTC with nodular fasciitis-like stroma should be renamed to PTC-DTF.