降钙素阴性的甲状腺神经内分泌肿瘤临床病理特征分析

摘要

目的 探讨降钙素阴性的甲状腺神经内分泌肿瘤的临床病理特征及鉴别诊断.方法 对1例诊断为降钙素阴性的甲状腺神经内分泌肿瘤病例进行病史收集、形态学检查及免疫表型检测,并复习相关文献.结果 52岁女性患者在我院行甲状腺全切术后,甲状腺右叶剖视见一直径0.6cm的灰白结节,边界欠清,切面实性、质中,镜下肿瘤细胞排列成巢团状,细胞呈卵圆形或梭形,胞浆中等,胞核较小,染色质粗颗粒状,核仁不明显,间质纤维组织增生,免疫表型:甲状腺转录因子1(TTF-1)、嗜铬素A(CgA)、突触素(Syn)和癌胚抗原(CEA)均弥漫阳性,甲状腺球蛋白(TG)、降钙素(CT)均阴性,Ki-67增殖指数＜1％.结论 降钙素阴性的神经内分泌肿瘤是一种罕见的甲状腺肿瘤,诊断需结合病理形态尤其是免疫表型.%Objective To explore the clinicopathological features and differential diagnosis of the calcitonin-negarive neuroendocrine tumor of thyroid.Methods A case of calcitonin-negative neuroendocrine tumor of thyroid was diagnosed.Then,the history of a case of calcitonin-negative neuroendocrine tumor of thyroid was collected.The morphological examination and the immunophenotype detection of the tumor had been conducted.In addition,the relative references were reviewed.Results A 52-year-old female patient underwent total thyroidectomy in our hospital,a gray and solid nodule,which is 0.6 cm in diameter,was found in the right lobe of thyroid,with blurred border and medium hardness.Under microscope,the tumorcells were composed of spindle cells or oval cells,with medium cytoplasm,small nuclear,coarse chromatin and unclear nucleoli.They arranged in nests with interstitial fibrous tissue proliferation.The immunophenotype examination indicated that TTF-1,CgA,Syn and CEA were all diffusely positive while TG and Calcitonin were negative.The index of Ki-67 proliferation was less than 1％.Conclusion Calcitonin-negative neuroendocrine tumor in thyroid is a rare tumor.Its diagnosis should rely on the pathological morphology and especially,on the immunophenotype examination.