背景:以前仅描述了一种具有纯小梁生长模式的甲状腺滤泡细胞源性肿瘤。本报告旨在描述组织学,免疫组织化学,和我们第二个病例的分子发现,提出了一种新的甲状腺肿瘤,并讨论其诊断缺陷。
方法:一名68岁女性患者,表现为由细长小梁组成的包囊状甲状腺肿瘤。没有乳头状,卵泡,固体,或观察到岛状图案。肿瘤细胞是细长的或梭形的,并垂直于小梁轴排列。未发现甲状腺乳头状癌的核发现和基底膜材料增加。免疫组织化学,肿瘤细胞配对盒基因8、甲状腺转录因子-1阳性,甲状腺球蛋白阴性,降钙素,和嗜铬粒蛋白A。未显示IV型胶原阳性材料的小梁间和小梁内积累。没有PAX8/GLIS1和PAX8/GLIS3和BRAF中的突变,HRAS,KRAS,NRAS,TERT启动子,CTNNB1,PTEN,并检测到RET。
结论:我们将我们的病例报告为一种新的疾病实体,称为非透明化小梁型甲状腺腺瘤,具有透明小梁瘤和甲状腺髓样癌的诊断缺陷。
BACKGROUND: Only one thyroid follicular cell-derived tumor with a purely trabecular growth pattern has previously been described. This report aims to describe the histological, immunohistochemical, and molecular findings of our second case, propose a novel thyroid tumor, and discuss its diagnostic pitfalls.
METHODS: A 68-year-old female presented with an encapsulated thyroid tumor composed of thin and long trabeculae. No papillary, follicular, solid, or insular patterns are observed. The tumor cells were elongated or fusiform and arranged perpendicular to the trabecular axis. No nuclear findings of papillary thyroid carcinoma and increased basement membrane material were found. Immunohistochemically, the tumor cells were positive for paired-box gene 8, thyroid transcription factor-1, and negative for thyroglobulin, calcitonin, and chromogranin A. Inter- and intra-trabecular accumulation of type IV collagen-positive materials was not demonstrated. None of PAX8/GLIS1 and PAX8/GLIS3 and mutations in BRAF, HRAS, KRAS, NRAS, TERT promoter, CTNNB1, PTEN, and RET were detected.
CONCLUSIONS: We report our case as a novel disease entity called non-hyalinizing trabecular thyroid adenoma, which has the diagnostic pitfalls of hyalinizing trabecular tumor and medullary thyroid carcinoma.