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对３９例伴有实性癌灶的分化型甲状腺癌进行了组织病理学和免疫组化观察，并与典型的分化型甲状腺癌和未分化癌比较，结果表明：（１）实性癌灶可分为岛状和片状两型，岛状型与其周围分化型癌分界清楚，癌细胞较小，形态较一致，应与髓样癌鉴别；片状型与分化型癌有移行，癌细胞有异型性和多型性，须与未分化癌鉴别。（２）两型实性癌灶的癌细胞甲状腺球蛋白表达阳性，降钙素和嗜络粒素Ａ为阴性，表明均来源于滤泡上皮，两者形态的差异可能与它们发生的机制不同有关。（３）分化型癌伴实性癌灶者侵袭性较强，颈淋巴结转移率较高，与典型的分化型癌比较差异有显著性，与未分化癌相比无显著差异。因此，认为部分实性癌灶可能是分化型癌向未分化癌转化的中间形式，在临床病理诊断中，应将其视为低分化癌
The histopathological and immunohistochemical observations of 39 cases of differentiated thyroid carcinoma with solid foci were performed. Compared with typical differentiated thyroid carcinoma and undifferentiated carcinoma, the results showed that: (1) solid foci can be Divided into island and flaky two types, island shape and its surrounding differentiated carcinoma clear boundaries, smaller cancer cells, more consistent form, should be differentiated from medullary carcinoma; flaky and differentiated carcinomas have migration, cancer cells have Heterogeneity and polymorphism must be differentiated from undifferentiated carcinoma. (2) The positive expression of thyroglobulin was positive in the two types of solid foci, and calcitonin and apogranin A were negative, indicating that they were all derived from follicular epithelium. The difference in the two forms may be different from the mechanism of their occurrence. related. (3) Differentiated carcinomas with solid tumors are more aggressive and have a higher rate of cervical lymph node metastases, and they are significantly different from typical differentiated carcinomas. There is no significant difference compared with undifferentiated carcinomas. Therefore, it is considered that part of the solid foci may be the intermediate form of differentiation from differentiated carcinoma to undifferentiated carcinoma. In clinicopathologic diagnosis, it should be regarded as poorly differentiated carcinoma.