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目的探讨甲状腺呈胸腺样分化癌(CASTLE)的病理特征。方法回顾性分析2例CASTLE的病理组织形态学特点及免疫组化染色结果,并复习相关文献资料。结果 2例CASTLE均位于甲状腺下极,质硬,与周围组织境界不清。镜下见上皮样肿瘤细胞呈岛状、巢状分布,浸润或穿插于甲状腺滤泡之间,细胞呈大的多边形,边界不清,细胞核呈圆形或卵圆形,染色质呈空泡状,核仁明显,核分裂象较为少见。免疫组化示肿瘤细胞表达CD5、CD117。结论 CASTLE是一种罕见的甲状腺恶性肿瘤,病理上其形态学与发生于胸腺的鳞形细胞癌相似,免疫组化有助于临床诊断,目前手术治疗是首选治疗方法,术后辅以放疗或化疗具有一定的疗效。
Objective To investigate the pathological features of thymus-like thyroid carcinoma (CASTLE). Methods The histopathological features and immunohistochemical staining of two cases of CASTLE were retrospectively reviewed. The related literatures were reviewed. Results Two cases of CASTLE were located in the lower pole of the thyroid gland, hard, and the surrounding tissue unclear. Microscopic see epithelial tumor cells were island-like, nest-like distribution, infiltration or interspersed between thyroid follicles, the cells were large polygons, the border is unclear, the nucleus was round or oval, chromatin vacuoles , Obvious nucleoli, mitosis more rare. Immunohistochemistry showed that tumor cells expressed CD5 and CD117. Conclusions CASTLE is a rare thyroid malignant tumor whose pathology is similar to that of squamous cell carcinoma in the thymus. Immunohistochemistry is helpful for clinical diagnosis. At present, surgical treatment is the first choice of treatment, and postoperative radiotherapy or Chemotherapy has a certain effect.