鞋钉样亚型甲状腺乳头状癌3例临床病理特征分析及文献复习
Clinicopathological Features of Hobnail Variant of Papillary Thyroid Carcinoma: A Report of 3 Cases and Review of the Literature

目的：探讨鞋钉样亚型甲状腺乳头状癌(hobnail variant of papillary thyroid carcinoma, HVPTC)的临床病理特征、诊断及鉴别诊断及预后。方法：回顾性分析３例HVPTC的临床特点、病理学特征、免疫表型及治疗预后，并复习相关文献。结果：HVPTC镜下为乳头、微乳头结构，表面覆盖着立方形或椭圆形上皮细胞，胞浆嗜酸，核质比高，细胞核位于顶部或偏心，向表面突起似鞋钉样，表达CK19、Galectin-3、TROP2、TTF1、PAX8等免疫组化标记，需与多种具有乳头/微乳头状结构的肿瘤相鉴别。结论：HVPTC临床少见，具有侵袭性，确诊需结合镜下特点和免疫表型。
Objective: To explore the clinicopathological features, diagnosis, differential diagnosis, and prognosis of hobnail variant of papillary thyroid carcinoma (HVPTC). Methods: The clinical features, pathological features, immunophenotype, and prognosis in 3 cases of HVPTC were retrospectively analyzed, and related literature was reviewed. Result: HVPTC was characterized by papillary and micropapillary structure under microscope. The surface of HVPTC was covered with cuboid or oval epithelial cells. The cytoplasm was acidophilic, and the ratio of nucleus to cytoplasm was high. The nucleus was located at the top or eccentric and protruded to the surface like a nail. The expression of CK-19, Galectin-3, TROP-2, TTF-1, PAX-8, and other immunohistochemical markers should be differentiated from many tumors with papillary and micropapillary structures. Conclusions: HVPTC is rare in clinic and invasive. The diagnosis of HVPTC should be made according to the microscopic characteristics and immunophenotype.