Asanuma K, Nishio A, Itoh N, Kasuga Y, Amano J
Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Endocr J. 2000 Jun;47(3):303-7. doi: 10.1507/endocrj.47.303.
We report a case of branchial cleft-like cysts (intrathyroidal lymphoepithelial cysts) associated with Hashimoto's thyroiditis. Palpation did not detect any nodules. Multiple cystic lesions were detected in the lateral side of the thyroid bilateral lobes by imagings of an I-123 scintigram, Tl-201 scintigram, sonography, and computerized tomography. Sonography displayed multiple cysts with strong echogenic spots in the cystic fluid. Repeated fine needle aspiration biopsies of the cysts consistently revealed only normal lymphocytes. Although these lesions could not be given diagnosis, subtotal thyroidectomy leaving the intact isthmus was performed. Microscopic findings revealed multiple branchial cleft-like cysts lined by flattened epithelial cells. Surrounding the epithelial lining were dense lymphoid follicles with large, reactive germinal centers. The remaining thyroid parenchyma showed Hashimoto's thyroiditis. Multiple branchial cleft-like cysts should be considered when sonographic examination reveals multiple cysts in the lateral side of the bilateral lobes, and fine needle aspiration biopsy displays only normal lymphocytes. To our knowledge, this is the first case of branchial cleft-like cysts associated with Hashimoto's thyroiditis reported in Japan.
我们报告一例与桥本甲状腺炎相关的鳃裂样囊肿（甲状腺内淋巴上皮囊肿）。触诊未发现任何结节。通过I - 123闪烁扫描、Tl - 201闪烁扫描、超声检查和计算机断层扫描成像，在双侧甲状腺叶外侧发现多个囊性病变。超声检查显示多个囊肿，囊液中有强回声光点。对囊肿反复进行细针穿刺活检，结果始终仅显示正常淋巴细胞。尽管这些病变无法确诊，但还是进行了保留完整峡部的甲状腺次全切除术。显微镜检查发现多个由扁平上皮细胞衬里的鳃裂样囊肿。上皮衬里周围是密集的淋巴滤泡，有大的、反应性生发中心。其余甲状腺实质显示为桥本甲状腺炎。当超声检查显示双侧叶外侧有多个囊肿，且细针穿刺活检仅显示正常淋巴细胞时，应考虑多个鳃裂样囊肿。据我们所知，这是日本报道的首例与桥本甲状腺炎相关的鳃裂样囊肿病例。
