桥本甲状腺炎合并原发性甲状腺淋巴瘤4例的临床病理分析
The clinical pathologic analysis of Hashimoto's thyroiditis complicated with primary thyroid lymphoma in 4 cases
-
摘要: 目的:观察桥本甲状腺炎(HT)合并原发性甲状腺淋巴瘤(PTL)的临床病理特征及免疫表型,探讨PTL的诊断、鉴别诊断、治疗及预后。方法:按WHO(2008)淋巴瘤分类标准,收集4例HT合并PTL,分析其临床病理特征、免疫组化分型并随访。结果:4例中女3例,男1例,年龄56~62岁。单侧甲状腺无痛性肿块常为首发症状。镜下表现为中等或较大的肿瘤性淋巴细胞弥漫浸润,可见残存的甲状腺腺体,腺体萎缩,并可见淋巴上皮病变。结论:甲状腺原发性淋巴瘤少见,与HT的发生密切相关,免疫组化标记有助于确诊,治疗以手术治疗辅助联合化疗、放疗等方案为宜。Abstract: Objective: To investigate the clinicopathologic features and immunophenotype of Hashimoto's thyroiditis(HT) complicated with primary thyroid lymphoma(PTL),and explore the diagnosis,differential diagnosis,treatment and prognosis of PTL.Methods: Four cases with HT complicated with PTL were collected according to the WHO classification standard of lymphomas(2008).The clinicopathologic features and immunophenotype of 4 cases were analyzed,and the patients were followed up.Results: Among 4 PTL cases,male in 1 case and female in 3 cases were found,and the age of the patients was from 56 to 62 years old.The unilateral painless thyroid masses was the primary symptom.The medium or large neoplastic lymphocyte infiltration,remaining thyroid gland,glandular atrophy and lymphoepithelial lesion were found under light microscope.Conclusions: The PTL is rare,which is closely related to the occurrence of HT.The immunohistochemical label can help the accurate diagnosis.The surgery combined with chemotherapy and/or radiotherapy is the suitable treatment.
-
Key words:
- thyroiditis /
- lymphoma /
- diagnosis,identification /
- pathology,clinic
-
[1] 沈志祥,朱荣增.恶性淋巴瘤[M].北京:人民卫生出版社,2011:952. [2] GRAFF-BAKER A,ROMAN SA,THOMAS DC,et al.Prognosis of primary thyroid lymphoma:demographic,clinical,and pathologic predictors of survival in 1408 cases[J].Surgery,2009,146(6):1105. [3] PEDERSEN RK,PEDERSEN NT.Primary non-Hodgkin's lymphoma of the thyroid gland:a population based study[J].Histopathology,1996,28(1):25. [4] HANS CP,WEISENBURGER DD,GREINER TC,et al.Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray[J].Blood,2004,103(1):275. [5] YESHVANTH SK,LAKSHMINARAYANA KP,UPADHYAYA VS,et al.Primary thyroid lymphoma arising from Hashimotos thyroiditis diagnosed by fine needle aspiration cytology[J].J Caner Res Ther,2012,8(1):159. [6] MALLOY KM,CUNNANE MF.Pathology and cytologic features of thyroid neoplasms[J].Surg Oncol Clin N Am,2008,17(1):57. [7] 霍真,李媛,崔全才,等.桥本甲状腺炎与甲状腺原发性淋巴瘤基因重排检测[J].中华病理学杂志,2006,35(6):344. [8] HA CS,SHADLE KM,MEDEIROS LJ,et al.Localized non-Hodgkin lymphoma involving the thyroid gland[J].Cancer,2001,91(4):629. [9] NAKADATE M,YOSHIDA K,ISHⅡ A,et al.Is 18F-FDG PET/CT useful for distinguishing between primary thyroid lymphoma and chronic thyroiditis?[J].Clin Nucl Med,2013,38(9):709. [10] ADAMCZEWSKI Z,STASIOŁEK M.et al.Flow cytometry in the differential diagnostics of Hashimoto's thyroiditis and MALT lymphoma of the thyroid[J].Endokrynol Pol, 2015,66(1):73. [11] DIBIASE SJ,GRIGSBY PC,GUO C,et al.Outcome analysis for stage IE and ⅡE thyroid lymphoma[J].Am J Clin Oncol,2004,27(2):178. [12] SAKORAFAS GH,KOKKORIS P,FARLEY DR.Primary thyroid lymphoma (correction of lympoma):diagnostic and therapeutic dilemmas[J].Surg Oncol,2010,19(4):e124. [13] PASIEKA JL.Hashimoto's disease and thyroid lymphoma:role of the surgeon[J].World J Surg,2000,24(8):966. [14] SUN TQ,ZHU XL,WANG CF,et al.Characteristics and prognosis of primary thyroid non-Hodgkin's lymphoma in Chinese patients[J].J Surg Oncol,2010,101(7):545. -

计量
- 文章访问数: 2860
- HTML全文浏览量: 521
- PDF下载量: 142
- 被引次数: 0