中国癌症杂志 ›› 2020, Vol. 30 ›› Issue (6): 462-467.doi: 10.19401/j.cnki.1007-3639.2020.06.009

• 论著 • 上一篇    下一篇

1例甲状腺孤立性纤维性肿瘤的临床病理学特征分析并文献复习

吴燕妮 1 ,赵 臣 2   

  1. 1. 徐州医科大学附属医院病理科,江苏 徐州 221002 ;
    2. 徐州市肿瘤医院头颈外科,江苏 徐州 221005
  • 出版日期:2020-06-30 发布日期:2020-07-16
  • 通信作者: 赵 臣 E-mail: 174106308@qq.com

Solitary fibrous tumor of thyroid: clinicopathologic analysis and literature review

WU Yanni 1 , ZHAO Chen 2   

  1. 1. Department of Pathology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, Jiangsu Province, China; 2. Department of Head and Neck Surgery, Xuzhou Cancer Hospital, Xuzhou 221005, Jiangsu Province, China
  • Published:2020-06-30 Online:2020-07-16
  • Contact: ZHAO Chen E-mail: 174106308@qq.com

摘要: 背景与目的:原发于甲状腺的孤立性纤维性肿瘤(solitary fibrosis tumor,SFT)非常罕见,探讨甲状腺SFT的临床病理学特征及鉴别诊断。方法:分析徐州医科大学附属医院收治的1例原发于甲状腺的SFT患者的临床资料、组织学及免疫组织化学特征,并复习相关英文文献。结果:患者男性,37岁,甲状腺右叶一边界清晰的肿物,直径3.2 cm。光镜下肿瘤由排列较密集的梭形细胞构成,无固定生长模式,少量胶原沉积,较多分支状血管形成。免疫表型信号转导及转录激活因子6(signal transducer and activator of transcription 6,STAT6)核弥漫强阳性,波形蛋白(vimentin)、CD34、CD99阳性,Bcl-2弱阳性。本例患者随访15个月,一般情况良好。英文文献报道中共25例患者有随访信息,随访时间5~160个月,仅1例恶性病例5个月后复发且有远处转移。结论:发生在甲状腺的SFT很罕见,通过特征性的组织学及免疫组织化学染色可以明确诊断,肿瘤多以良性为主,预后良好,恶性少见,易复发转移。确切的生物学行为需要长期随访,治疗首选手术切除。

关键词: 孤立性纤维性肿瘤, 甲状腺, 免疫组织化学, 信号转导及转录激活因子6

Abstract: Background and purpose: Primary solitary fibrous tumor (SFT) of thyroid is very rare. This study aimed to explore the clinicopathological features and identification of thyroid SFT. Methods: We analyzed one case of primary thyroid SFT treated in Affiliated Hospital of Xuzhou Medical University, including the clinical manifestations, histological features and immunohistochemical phenotypes, and reviewed the relevant English literature. Results: The patient was a 37-year-old male with a well-circumscribed mass in the right lobe of the thyroid gland, and the mass was 3.2 cm in diameter. Microscopically, the tumor displayed proliferation of spindle cells growing in nonspecific “patternless” manner with few amounts of intercellular collagen bundles. The tumor vessels showed branching staghorn-like appearance. Immunohistochemistry showed the spindle cells were positive for signal transducers and activators of transcription 6 (STAT6) (strong, nuclear), vimentin, CD34, CD99 and Bcl-2 (weak). The patient was followed up for 15 months and in good condition. A total of 25 cases reported in the English literature were followed up for 5-160 months. Only one malignant case had reccurrence and metastasis after 5 months. Conclusion: Thyroid SFT is an uncommon neoplasm, and histopathology and immunohistochemistry can confirm the diagnosis. Most of the tumors are benign with good prognosis. Malignant cases are rare with the risk of recurrence and metastasis. Long-term follow-up is essential to evaluate the prognosis, and surgical resection is the preferred treatment for SFT.

Key words: Solitary fibrous tumor, Thyroid, Immunohistochemistry, Signal transducers and activators of transcription 6