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目的探讨鼻咽部甲状腺样低级别乳头状腺癌(TL-LGNPPA)的临床病理学特点、诊断与鉴别诊断要点。方法报道1例鼻咽部甲状腺样低级别乳头状腺癌的临床及影像学资料,行HE染色、免疫组化标记及分子病理检测,分析其临床病理特征并随访患者预后,以及复习相关文献。结果患者女性,47岁。镜下肿瘤主要由具有纤维血管轴心的树枝状乳头、管状腺体和梭形细胞区构成。腺体不规则,呈囊状或管状,乳头和管腔表面被覆单层或假复层柱状上皮。瘤细胞圆形或卵圆形,核仁不明显,未见核分裂。免疫组化:肿瘤细胞CK7、CK19和TTF-1(+),TG、CD15和CK5/6(-)。原位杂交检测示EBER(-),BRAF基因1799位点15外显子(BRAFV600E)无突变。随访3年,无复发。结论原发性鼻咽部甲状腺样低级别乳头状腺癌是一种非常罕见的低度恶性肿瘤,明确诊断需结合病理组织学形态和免疫表型。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of nasopharyngeal thyroid low grade papillary adenocarcinoma (TL-LGNPPA). Methods One case of low grade thyroid papillary adenocarcinoma of the nasopharynx was reported by clinical and imaging data. HE staining, immunohistochemical staining and molecular pathological examination were performed. The clinicopathological features were analyzed and the prognosis was followed up. Results Patients Female, 47 years old. Microscopic tumors mainly consist of dendritic papillae with tubular axes of fibroids, tubular glands and spindle cells. Irregular glandular, cystic or tubular, nipple and luminal surface covered with single or pseudostratified columnar epithelium. Tumor cells were round or oval, nucleoli are not obvious, no nuclear fission. Immunohistochemistry: tumor cells CK7, CK19 and TTF-1 (+), TG, CD15 and CK5 / 6 (-). In situ hybridization showed that there was no mutation in EBER (-) and BRAF gene exon 15 (BRAFV600E) at 1799 locus. Follow-up for 3 years, no recurrence. Conclusions Primary nasopharyngeal low-grade thyroid papillary adenocarcinoma is a very rare low-grade malignant tumor. It is necessary to combine histopathology and immunophenotype with definite diagnosis.