Schneider P W, Meier D A, Balon H
Department of Nuclear Medicine, William Beaumont Hospital, Royal Oak, Michigan 48073-6769, USA.
Thyroid. 2000 Mar;10(3):269-73. doi: 10.1089/thy.2000.10.269.
We report a case of an autonomously functioning thyroid nodule (AFTN) that proved to be almost exclusively a clear cell variant of follicular carcinoma. AFTNs are generally felt to be benign lesions with exceptions forming the basis of case reports. Likewise, clear cell tumors of the thyroid are rare. To our knowledge, this combination of two unusual thyroid conditions has not been previously reported. The initial scans of this patient were so characteristic for a degenerating AFTN that attention was first directed toward a very large contralateral lobe. While it is debatable whether all AFTNs should be biopsied, on the basis of this and other cases, it is recommended that AFTNs that contain a central photopenic area on scan be biopsied to be sure that cystic degeneration, a commonly seen phenomenon in larger AFTNs, is indeed present rather than a malignancy.
我们报告一例自主功能性甲状腺结节（AFTN），结果证明几乎完全是滤泡癌的透明细胞变体。AFTN通常被认为是良性病变，但也有例外情况成为病例报告的基础。同样，甲状腺透明细胞瘤也很罕见。据我们所知，此前尚未报道过这两种不寻常的甲状腺疾病的组合。该患者的初始扫描结果对一个正在退变的AFTN非常具有特征性，以至于注意力首先指向了对侧一个非常大的叶。虽然是否所有AFTN都应进行活检存在争议，但基于此病例及其他病例，建议对扫描显示有中央放射性缺损区的AFTN进行活检，以确定是否确实存在较大AFTN中常见的囊性退变，而非恶性肿瘤。
