伴有淋巴样间质的微结节型胸腺瘤2 例并文献复习
| 作者: |
1徐园园,
2赖均鹏,
1毛荣军,
1谢乐,
1韩福兰,
1吴燕杏,
1曾敏
1 广州中医药大学附属佛山市中医院病理科，广东 佛山 528000 2 中山大学肿瘤防治中心病理科，广州 510060 |
| 通讯: |
赖均鹏
Email: Laijp@sysucc.org.cn |
| DOI: | 10.3978/j.issn.2095-6959.2018.06.036 |
| 基金: | 佛山市十三五医学重点专科建设项目(FSZDZK135018) |
摘要
2例伴有淋巴样间质的微结节型胸腺瘤(micronodular thymoma with lymphoid stroma，MNT)发病年龄52，63岁，均为女性，分别为纵隔囊实性肿物和胸骨上窝实性肿物，无重症肌无力及自身免疫疾病等。瘤组织以丰富淋巴细胞间质分隔的散在上皮性结节为特征，上皮性结节的细胞呈梭形或卵圆形，形态温和，未见病理性核分裂及坏死，淋巴细胞间质可见具生发中心的滤泡。免疫组织化学上皮细胞CK，CK5/6，p63(+)，CD99散在(+)，EMA囊性变区域(+)，CD117(−)；淋巴细胞间质包含B和T细胞，以CD20(+)的B细胞为主，成熟T细胞CD3，CD5(+)，而TdT，CD1α，CD99阳性的未成熟T细胞分布在上皮结节周围，少数散在分布在上皮结节内。MNT非常罕见，具有恶性潜能，恶性MNT具有低度恶性生物学行为，极少数病例可出现死亡，其上皮细胞成分和淋巴细胞间质都有恶变的可能。恶性的MNT很可能是一个连续有移行的过程。MNT的治疗中，完整切除肿物并保证肿物切缘未受肿瘤累及是至关重要的。
关键词：
伴有淋巴样间质的微结节型胸腺瘤；临床病理学特征；复发与转移；生物学行为
Case report and literature review of micronodular thymoma with lymphoid stroma
CorrespondingAuthor: LAI Junpeng Email: Laijp@sysucc.org.cn
DOI: 10.3978/j.issn.2095-6959.2018.06.036
Foundation: This work was supported by Foshan Thirteenth Five-Year Medical Major Project Foundation, China (FSZDZK135018)
Abstract
Two patients with micronodular thymoma with lymphoid stroma (MNT) were 52 and 63 years old, female, without myasthenia gravis or autoimmune disease, the mediastinal mass was cystic degenerated, while suprasternal fossa mass was solid. The tumor tissue of MNT was characterized by scattered or local confluent epithelial nodules which separated by rich lymphocyte. The cells of epithelial nodules were spindle or ovoid with moderate morphology, without pathological nuclear fission and necrosis, follicle with germinal center can be seen in lymphocyte interstitium. Immunohistochemical expression in epithelial cells of CK, CK5/6, p63 were positive, CD99 was scattered positive, EMA was positive in cystic area, CD117 was negative. Lymphocyte interstitium contains B and T cells, the major ingredient were B cells, positive for CD20; CD3 and CD5 were positive in mature T cells; TdT, CD1α, CD99 were positive for immature T cell spread around the epithelial nodules, few of them scattered in the epithelial nodules. MNT was exceedingly rare low-grade potential malignant tumor, malignant MNT had low-grade malignant biological behavior, very few cases were fatal. Its epithelial cells and lymphocyte interstitial cells might undergo malignant transformation. Malignant MNT was likely to be a continuous migration process. Complete resection of the tumor and ensure that the cutting edge was not affected should be most important to the treatment of MNT.
Keywords：
micronodular thymoma with lymphoid stroma; clinicopathological characteristics; recurrence and metastasis; biological behavior