Abstract:
Solitary fibrous tumour is a relatively rare soft tissue fibroblastic tumour, accounting for approximately 2% of soft tissue tumours. It has been described primarily as a tumour of the pleural cavity; however, up to 70% of cases occur elsewhere, in any anatomical location, which can make diagnosis difficult. If this is the diagnosis being considered, the STAT6 antibody is currently available with high sensitivity and specificity. In this paper we describe the case of a 72-year-old female patient, followed up and treated by an outpatient endocrinologist for a multinodular euthyroid goitre for several years. Due to complete nodular remodelling of the left lobe of the thyroid gland and sonographic findings of several small nodules in the right lobe of the thyroid gland, total thyroidectomy was recommended to the patient. The operation was performed at the ENT department in Jindřichův Hradec Hospital. Material from the operation was subsequently sent for histopathological examination. Several hyperplastic colloid nodules and a small oncocytic adenoma were detected microscopically in the right lobe of the thyroid gland. In the left lobe, an imprecisely delineated, greyish-white lesion measuring 2 x 1.8 x 1.5 cm was observed on the section. Microscopically, the tumour consisted of spindle-shaped cells in a focally hyalinised stroma. In the immunohistochemical examination, tumour cells reacted positively with the CD34 antibody, and negatively with antibodies against thyroglobulin, cytokeratins (CK AE1/AE3) and S100 protein. Further immunohistochemical examinations (Bcl2, CD99, STAT6) with positive results were supplemented upon consultation at a higher facility. Based on morphology and the results of the immunohistochemical examinations, the tumour was diagnosed as a solitary fibrous tumour of the thyroid gland. This is a relatively unusual finding in this location; according to literature, only a few dozen cases have been described.
摘要:
孤立性纤维瘤是一种相对罕见的软组织成纤维细胞瘤,约占软组织肿瘤的2%。它主要被描述为胸膜腔的肿瘤;然而,高达70%的病例发生在其他地方,在任何解剖位置,这会使诊断变得困难。如果这是正在考虑的诊断,STAT6抗体目前具有高灵敏度和特异性.在本文中,我们描述了一名72岁的女性患者的情况,随访并由门诊内分泌学家治疗甲状腺多结节性甲状腺肿。由于甲状腺左叶完全结节状重塑和甲状腺右叶几个小结节的超声检查结果,建议患者行甲状腺全切除术.该手术是在Jind之所以伊希夫Hradec医院的耳鼻喉科进行的。随后将手术材料送去进行组织病理学检查。显微镜下在甲状腺右叶发现了几个增生性胶体结节和一个小的嗜酸细胞腺瘤。在左叶,一个不精确的划定,在切片上观察到2x1.8x1.5cm的灰白色病变。微观上,肿瘤由局灶性透明基质中的纺锤形细胞组成。在免疫组织化学检查中,肿瘤细胞与CD34抗体呈阳性反应,对甲状腺球蛋白抗体呈阴性,细胞角蛋白(CKAE1/AE3)和S100蛋白。在较高机构咨询后,补充了具有阳性结果的进一步免疫组织化学检查(Bcl2,CD99,STAT6)。根据形态学和免疫组织化学检查结果,该肿瘤被诊断为甲状腺的孤立性纤维瘤。这在这个地方是一个相对不寻常的发现;根据文献,只描述了几十个案例。