Primary mucinous carcinoma of thyroid gland with prominent signet-ring-cell differentiation: a case report and review of the literature.
Primary mucinous carcinoma of thyroid gland with prominent signet-ring-cell differentiation: a case report and review of the literature.
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印戒细胞分化显着的原发性甲状腺粘液癌一例报告及文献复习
DOI：
10.2147/ott.s158975
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发表时间：
2018
影响因子：
4
通讯作者：
Liu Y
中科院分区：
文献类型：
--
作者：
Wang J;Guli QR;Ming XC;Zhou HT;Cui YJ;Jiang YF;Zhang D;Liu Y
目的报告1例原发性甲状腺黏液癌伴印戒细胞分化，复习文献，探讨其真实发病率及预后。患者和方法一名74岁的中国女性，以甲状腺右叶肿块就诊。计算机断层扫描显示甲状腺右叶肿块，伴右颈部淋巴结肿大和肿瘤压迫引起的气道偏曲。甲状腺影像学提示甲状腺恶性肿瘤及可疑淋巴结转移。组织学表现为肿瘤细胞呈小巢状或小梁状排列，细胞外黏液基质丰富。肿瘤细胞在甲状腺滤泡间形成弥漫性浸润。在外周区域，突出的印戒细胞形成片状结构并延伸到甲状腺外脂肪组织。肿瘤细胞弥漫性表达甲状腺转录因子-1 （TTF-1）和PAX8阳性，泛细胞角蛋白（AE1/AE3）和弱表达甲状腺球蛋白呈局灶性阳性。结果根据组织学特征和免疫组化特征，诊断原发性甲状腺粘液癌伴印戒细胞分化。结论免疫组化标志物可用于鉴别诊断和判断肿瘤是否原发。
Purpose This study reports a case of primary mucinous carcinoma of the thyroid gland with signet-ring-cell differentiation, and reviews the literature to evaluate its real incidence and the prognosis of these patients. Patients and methods A 74-year-old Chinese woman, presenting with a mass in the right lobe of thyroid gland, came to the hospital. Computed tomography revealed a mass in the right lobe of the thyroid gland, accompanied with right neck lymphadenectasis and airway deviation caused by tumor compression. Thyroid imaging suggested a thyroid malignant tumor and suspicious lymph node metastasis. Histologically, the tumor was characterized by the tumor cells arranged in small nests or trabeculae with an abundant extracellular mucoid matrix. The tumor cells formed diffuse invasion among thyroid follicles. In the peripheral regions, prominent signet-ring-cells formed a sheet-like structure and extended into the extrathyroidal fat tissue. The tumor cells were diffusely positive for thyroid transcription factor-1 (TTF-1) and PAX8, while they were focally positive for pan-cytokeratin (AE1/AE3) and weakly expressed thyroglobulin. Results Based on the histological features and immunohistochemical profile, a diagnosis of primary mucinous carcinoma of the thyroid gland with signet-ring-cell differentiation was rendered. Conclusion Using a panel of immunohistochemical markers may be helpful for differential diagnosis and for determining whether the tumor is primary or not.