CAJ | 학술논문

目的探讨卵巢甲状腺类癌的临床病理特征、诊断及鉴别诊断.方法对2例发生在卵巢甲状腺类癌病例应用免疫组化Syn,CgA,S-100,CT,Vimtime,Tg,CK,NSE,P63,Ki67,CEA,α-inhibin进行检测,并结合相关文献进行讨论.结果 2例患者均为绝经后女性,例1患者以盆腔包块为主要表现,伴有便秘,血CA199升高,例2患者因手术切除其他肿瘤及附件,送病理活检发现.2例患者巨检肿瘤均为单纯型.镜检肿瘤均由甲状腺组织及类癌组织构成,类癌为梁状与岛状混合型.免疫组化:2例患者类癌细胞Syn(2/2+),CgA(2/2+),NSE(1/2+),Ki67(3％+,5％+),CK(1/2+),S-100(2/2-),CEA(2/2-),P63(2/2-),CT(2/2-),Vimtime(2/2-),Tg(2/2-),α-inhibin(2/2-);甲状腺滤泡Tg(2/2+),CK(2/2+),Vimtime(1/2+),Syn(2/2-),CgA (2/2-),NSE(2/2-),Ki67(2/2-),S-100(2/2-),CEA(2/2-),P63(2/2-),CT(2/2-),α-inhibin(2/2-).2例患者均为Ⅰ期,例1患者术后行化疗,例2术后未做任何治疗,分别随访57个月及2个月,均未见复发及转移.结论卵巢甲状腺类癌是一种非常罕见的具有独特临床病理学特征的高度特殊性生殖细胞肿瘤,伴有甲状腺组织分化,一般预后良好,要与小圆形细胞肿瘤鉴别,结合免疫组化,可与之鉴别.
목적 탐토란소갑상선유암적림상병리특정、진단급감별진단.방법 대2례발생재란소갑상선유암병례응용면역조화Syn,CgA,S-100,CT,Vimtime,Tg,CK,NSE,P63,Ki67,CEA,α-inhibin진행검측,병결합상관문헌진행토론.결과 2례환자균위절경후녀성,례1환자이분강포괴위주요표현,반유편비,혈CA199승고,례2환자인수술절제기타종류급부건,송병리활검발현.2례환자거검종류균위단순형.경검종류균유갑상선조직급유암조직구성,유암위량상여도상혼합형.면역조화:2례환자유암세포Syn(2/2+),CgA(2/2+),NSE(1/2+),Ki67(3％+,5％+),CK(1/2+),S-100(2/2-),CEA(2/2-),P63(2/2-),CT(2/2-),Vimtime(2/2-),Tg(2/2-),α-inhibin(2/2-);갑상선려포Tg(2/2+),CK(2/2+),Vimtime(1/2+),Syn(2/2-),CgA (2/2-),NSE(2/2-),Ki67(2/2-),S-100(2/2-),CEA(2/2-),P63(2/2-),CT(2/2-),α-inhibin(2/2-).2례환자균위Ⅰ기,례1환자술후행화료,례2술후미주임하치료,분별수방57개월급2개월,균미견복발급전이.결론 란소갑상선유암시일충비상한견적구유독특림상병이학특정적고도특수성생식세포종류,반유갑상선조직분화,일반예후량호,요여소원형세포종류감별,결합면역조화,가여지감별.
Objective Ovarian carcinoid tumor of the thyroid clinical and pathological features,diagnosis and differential diagnosis.Methos Two cases of thyroid gland in ovarian carcinoid cases with immunohistochemical Syn,CgA,S-100,CT,Vimtime,Tg,CK,NSE,P63,Ki67,CEA,α-inhibin were detected,and discussed with relevant literature.Results Two patients were postmenopausal women,example 1 in patients with pelvic mass as the main performance,accompanied by constipation,elevated blood CA199,example 2 patients due to surgical removal of tumors and other accessories,sent to biopsy findings.Two patients with giant tumors are of simple inspection.Microscopic examination of thyroid tissue and carcinoid tumor by tissue composition,trabecular carcinoid is mixed with the island.Immunohistochemistry:Class 2 patients cancer Syn(2 / 2 +),CgA(2 / 2 +),NSE(1 / 2 +),Ki67(3％ +,5％ +),CK(1 / 2 +),S-100(2/2-),CEA(2/2-),P63(2/2-),CT(2/2-),Vimtime(2/2-),Tg(2/2-),o-inhibin(2/2-); Thyroid follicular Tg(2 / 2 +),CK(2 / 2 +),Vimtime(1 / 2 +),Syn(2/2-),CgA(2/2-),NSE(2/2-),Ki67(2/2-),S-100(2/2-),CEA(2/2-),P63(2/2-),CT(2/2-),α-inhibin(2/2-).Two patients were stage Ⅰ,example 1 postoperative chemotherapy,example 2 without making any treatment after surgery,were followed up for 57 months and 2 months,showed no recurrence and metastasis.Conclusion Ovarian carcinoid tumor of thyroid is a very rare clinical and pathological features of the unique specificity of a high degree of germ cell tumors,associated with thyroid tissue differentiation,generally good prognosis,with the identification of small round cell tumor,combined with immunohistochemistry,can identify with them.