摘要
Abstract
Objective To explore the clinical and pathological characteristics of medullary thyroid carcinoma(MTC)combined with papillary thyroid carcinoma(PTC),and to improve the detection rate of mixed thyroid tumors.Methods A retrospective analysis was conducted on the clinicopathological data of 11 cases of MTC combined with PTC diagnosed in the Department of Pathology,Jiangsu Province Hospital on Integration of Chinese and Western Medicine from April 2010 to April 2025,and analysis.Results Among the 11 patients,there were 4 males and 7 females with a median age of 57 years.The preoperative puncture pathology of 11 cases was not diagnosed as MTC combined with PTC.All patients underwent intraoperative rapid pathological diagnosis.Among them,5 cases were MTC combined with PTC,3 cases were PTC combined with thyroid follicular neoplasm,and the rest were diagnosed with single tumor(PTC or MTC).Conventional pathology diagnosed that all 11 patients had MTC combined with PTC,among which 2 cases were mixed MTC-PTC,and 6 cases were combined with multinodular goiter,and 3 cases combined with chronic lymphocytic thyroiditis.The histological morphology of MTC and PTC was diverse,presenting in arrangements such as papillary,island,follicular or solid.MTC cells are round,oval,spindle-shaped or plasma cell-like,with indistinct boundaries.The cytoplasm is eosinophilic,bicolotropic or transparent.The nucleus is round,irregular or spindle-shaped,with rough chromatin that does not have the characteristics of PTC cell nuclei.Amyloid deposits are seen in the interstitium.Immunohistochemistry expresses calcitonin(CT)and carcinoembryonic antigen(CEA),but does not express thyroglobulin(Tg).Special staining shows Congo red as brick red,and under a polarizing microscope,it appears as a refractive apple green.The nuclei of PTC cells are round or oval,and the cytoplasm is eosinophilic or bicolotropic.The nuclei are enlarged and arranged in a crowded manner.Nuclear grooves and pseudo-inclusions within the nucleus can be seen.Immunohistochemistry expressed thyroid transcription factor-1,paired box gene 8,and mesothelial cell membrane protein protenin mesothelial cell membrane protenin-1,Tg,galectin-3,cytokeratin are not expressed.CT and CEA are not expressed.Special staining is negative for Congo red.Conclusion MTC combined with PTC is relatively rare.There are no special manifestations in clinical features and imaging examinations.Preoperative puncture pathology and intraoperative rapid pathology are difficult to make a clear diagnosis.Clinicians and pathologists should avoid missed diagnoses or misdiagnoses.关键词
甲状腺髓样癌/甲状腺乳头状癌/甲状腺髓样癌合并乳头状癌/病理Key words
Medullary thyroid carcinoma/Papillary thyroid carcinoma/Medullary thyroid carcinoma combined with papillary carcinoma/Pathology分类
医药卫生
