Anaplastic thyroid carcinoma with osteoclast-like giant cells: a case report and a study of a potential therapeutic approach.

IF 1.1 4区 医学 Q3 PATHOLOGY
Kaori Yukino, Yoshihiro Komohara, Shukang Zhao, Rin Yamada, Yukio Fujiwara, Akira Murakami, Yu Shimoda, Haruki Saito, Yorihisa Orita
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引用次数: 0

Abstract

Anaplastic thyroid carcinoma (ATC) is a highly aggressive neoplasm with no effective treatment options. ATC with osteoclast-like giant cells (OGCs; ATC/OGC) is a rare variant of ATC, and no detailed pathological examination has been reported to date. A 59-year-old woman presented with sudden neck swelling. Computed tomography revealed a 5 cm tumor in the thyroid gland, which was surgically resected. Pathological examination revealed a diagnosis of ATC/OGC. The patient succumbed to progressive lung metastases within four months despite postoperative lenvatinib therapy. Immunohistochemical (IHC) examination indicated absence of PD-L1 expression in the OGCs, which comprised the majority of the tumor, with only sparse T cell infiltration in the area occupied by OGCs. Increased TGF-β expression was observed in the area containing OGCs, and both OGCs and infiltrating myeloid cells, including CD1a/CD11c-positive dendritic cells and CD68/CD163/CD204-positive macrophages, appeared to produce TGF-β. Pathological analysis of this case suggests that OGCs might be involved in immune suppression by secreting TGF-β, potentially serving as a critical cytokine in the immunosuppressive microenvironment of ATC/OGC. TGF-β-targeted therapy might be useful in the treatment of this very rare subtype of ATC.

甲状腺间变性癌伴破骨细胞样巨细胞:一例报告及一种潜在治疗方法的研究。
间变性甲状腺癌(ATC)是一种高度侵袭性的肿瘤,没有有效的治疗选择。ATC与破骨细胞样巨细胞(OGCs);ATC/OGC是一种罕见的ATC变异型,至今未见详细的病理检查报告。59岁女性,颈部突然肿胀。计算机断层扫描显示甲状腺有一个5厘米的肿瘤,手术切除。病理诊断为ATC/OGC。尽管术后lenvatinib治疗,患者仍在4个月内死于进展性肺转移。免疫组化(IHC)检查显示,占肿瘤大部分的OGCs中缺乏PD-L1表达,仅在OGCs占据的区域有稀疏的T细胞浸润。TGF-β在OGCs中表达增加,OGCs和浸润性骨髓细胞(包括CD1a/ cd11c阳性树突状细胞和CD68/CD163/ cd204阳性巨噬细胞)均产生TGF-β。本病例病理分析提示,OGC可能通过分泌TGF-β参与免疫抑制,可能是ATC/OGC免疫抑制微环境中的关键细胞因子。TGF-β靶向治疗可能有助于治疗这种非常罕见的ATC亚型。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Medical Molecular Morphology
Medical Molecular Morphology 医学-病理学
CiteScore
2.90
自引率
5.60%
发文量
30
审稿时长
>12 weeks
期刊介绍: Medical Molecular Morphology is an international forum for researchers in both basic and clinical medicine to present and discuss new research on the structural mechanisms and the processes of health and disease at the molecular level. The structures of molecules, organelles, cells, tissues, and organs determine their normal function. Disease is thus best understood in terms of structural changes in these different levels of biological organization, especially in molecules and molecular interactions as well as the cellular localization of chemical components. Medical Molecular Morphology welcomes articles on basic or clinical research in the fields of cell biology, molecular biology, and medical, veterinary, and dental sciences using techniques for structural research such as electron microscopy, confocal laser scanning microscopy, enzyme histochemistry, immunohistochemistry, radioautography, X-ray microanalysis, and in situ hybridization. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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