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两例上腺囊与甲状腺状上皮相结合:解决细胞起源和恶性瘤问题
Maki Kanzawa1, Tomonori Kanda2, Hidenori Fukuoka3
1Department of Diagnostic Pathology, Kobe University Hospital, Kobe, 650-0017, Japan.
JCEM case reports
|April 16, 2024
概括
在上腺囊中异胎性甲状腺组织是罕见的. 虽然难以诊断,但这些上腺囊被甲状腺毛囊上皮层所覆盖,需要仔细评估,以区分甲状腺癌转移.
科学领域:
- 内分泌学 在内分泌学.
- 手术病理学手术病理学
- 在瘤学瘤学.
背景情况:
- 由甲状腺毛囊上皮层覆盖的上腺囊非常罕见,仅有14例异胎性甲状腺组织报告.
- 将这些与转移性甲状腺癌区分开来是至关重要的,但具有挑战性.
研究的目的:
- 报告两例上腺囊的新病例,这些囊被甲状腺毛囊表皮所包围.
- 讨论这些罕见实体的诊断挑战和免疫类型特征.
主要方法:
- 对两名上腺囊患者的病例报告分析.
- 组织病理学检查包括免疫组织化学 (IHC) 检查CK19,加勒-3,CD56和人类骨髓内皮细胞标记-1.
- 针对基因改变的下一代测序 (NGS).
主要成果:
- 两位患者都接受了上腺切除术,以扩大上腺囊.
- 组织病理学揭示了甲状腺毛囊表皮层囊,与中度的异型.
- 免疫组织化学检测显示CK19, galectin-3,人类骨髓内皮细胞标志物-1和CD56.6的可变阳性.
- NGS检测到低频突变,但没有典型的甲状腺癌的主要驱动因素改变.
结论:
- 上腺囊可以由宫外甲状腺毛囊表皮层线.
- 免疫类型可以模仿甲状腺癌,使诊断复杂化.
- 确定这些上腺囊的良性或恶性性质仍然是一个诊断挑战.
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