| 李杨,郭昆亮,詹必成,等.以胸腺囊肿为首发症状的胸腺肠型腺癌 1例并文献复习[J].安徽医药,2024,28(8):1636-1639. |
| 以胸腺囊肿为首发症状的胸腺肠型腺癌 1例并文献复习 |
| A case of thymic enteric adenocarcinoma with the first symptom of thymic cyst and literature review |
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| DOI：10.3969/j.issn.1009-6469.2024.08.032 |
| 中文关键词: 胸腺肿瘤 肠型腺癌 病理学特征 免疫表型 诊断 鉴别诊断 |
| 英文关键词: Thymus neoplasms Enteric adenocarcinoma Clinicopathological features Immunophenotypic features Diagno- sis Differential diagnosis |
| 基金项目:安徽医科大学校科研基金项目(2020XKJ240) |
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| 中文摘要: |
| 目的探讨胸腺肠型腺癌(TEAC)的临床病理学特征、免疫表型特征、诊断及鉴别诊断。方法回顾性分析 2023年 4月 20日安庆市立医院收治的 1例 TEAC的临床病理学特征，行免疫组化 EnVision两步法进行检测，并复习相关文献。结果病人女性，47岁，因咳嗽 10 d，体检发现纵膈占位 1d入院行肿瘤切除术，镜下病变呈多房囊性病变，肿瘤呈多灶性，散在分布囊壁的纤维及脂肪内，组织学表现为管状腺癌及黏液腺癌，主要由柱状上皮、胞质含黏液上皮细胞及潘氏样细胞组成。部分区域可见肿瘤细胞与温和的梭形胸腺上皮过渡移行。免疫表型:肿瘤细胞 CDX2、CK7、MUC-2、CD117、SATB2、CEA、CK20均阳性，P53错义突变，CD20、P63阴性，Ki67增殖指数约 20%。Masaoka-Koga分期:Ⅰ期；TNM分期:Ⅰ期。结论胸腺肠型腺癌是一种罕见胸腺的原发腺癌，临床症状无特异性，常与胸腺囊肿伴随，具有与结直肠腺癌相同的组织学和免疫组化特征，无特异性分子诊断指标。诊断及鉴别诊断重点是排除转移性恶性肿瘤。病人术后无进展，治疗建议参考其他常见胸腺癌。 |
| 英文摘要: |
| Objective To investigate the clinicopathological features, immunophenotypic features, diagnosis and differential diagno-sis of thymic enteric adenocarcinoma (TEAC).Methods The clinicopathological features of 1 case of TEAC admitted to Anqing Mu-nicipal Hospital on April 20, 2023 were analyzed retrospectively, and a two-step immunohistochemical EnVision assay was performed and the relevant literature was reviewed.Results The patient, a 47-year-old female, was admitted to the hospital for tumor resectiondue to cough for 10 days and mediastinal occupancy found on physical examination for 1 day. The lesions were multilocular cystic le-sions under the microscope, and the tumors were scattered in the fibers and fats of the cyst wall. The tumor was tubular adenocarcinomaand mucinous adenocarcinoma, mainly composed of columnar epithelium, cytoplasmic mucous epithelium and Panoid cells. In some ar-eas, transition of tumor cells to mild fusiform thymus epithelium was observed. Immunophenotype: CDX2, CK7, MUC-2, CD117,SATB2, CEA and CK20 expression were positive, P53 showed missense mutation, CD20 and P63 expression was negative, Ki-67 prolif- eration index was about 20%. Masaoka-Koga stage:Ⅰstage; TNM stage:Ⅰstage.Conclusions Thymic intestinal adenocarcinoma is arare primary adenocarcinoma of the thymus, with no specific clinical symptoms, often associated with thymic cysts, with the same histo-logical and immunohistochemical features as colorectal adenocarcinoma, no specific molecular diagnostic indicators. The diagnosticand differential diagnosis focuse on the exclusion of metastatic malignancies. The patient had no postoperative progression and thetreatment recommendations refer to other common thymic carcinomas. |
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