【摘要】 目的探讨桥本甲状腺炎(HT)合并甲状腺微小癌(TMC)的临床病理特征。方法回顾性分析17例HT合并TMC的临床病理资料,15例做细胞角蛋白19(CK19)免疫组化染色。结果17例29个癌灶,均为甲状腺乳头状微小癌(TPMC)(直径0.2~1.0cm),与HT病变混合存在呈"播种状"。HT病变与癌灶之间有上皮细胞过度增生-非典型增生-微小癌的移行过渡带。15例乳头状微小癌CK19均强阳性表达,部分病例非典型增生的滤泡上皮阳性表达强弱不一,HT中相对正常滤泡上皮阴性。结论HT是1种具有恶变潜能的病变,与TMC发生关系密切。HT合并TMC临床诊断困难,仔细的标本检查是提高检出率的关键。更多还原

【Abstract】 Objective To study the clinicopathological features of the Hashimoto’s thyroiditis (HT) coexisted thyroid microcarcinoma(TMC).Methods 17 cases with HT coexistd TMC were retrospectively analysed.Immunohistochemical study of the cytokeratin19(CK19) was performed in 15 cases.Results 29 carcinous regions in 17 cases were all thyroid palliary microcarcinoma (TPMC),with the diameter from 0.2 to 1.0 cm.The TPMC mixed with HT like "planting-seeds" .The transformation from epithelial cell hyperplasia to atypical hyperplasia and to TMC was observed in the tissue from HT coexisted TMC.CK19 was highly positive in all 15 TPMC.The expression of CK19 in the area of the atypical hyperplasia of the follicular epithelial cells was positive in various degrees.The normal follicular epithelial cells in HT had negative CK19 expression.Conclusion HT is a potential malignant disease and is closely associated with TMC.The clinical diagnosis of coexistence of HT and TMC is still difficult.Careful examination of the sample from surgical resection is the key to improve the diagnosis rate.更多还原