Korpal-Szczyrska Maria J, Kamińska Halina, Dorant Bohdana A, Birkholz Dorota E
Kliniki Pediatrii, Hematologii, Onkologii i Endokrynologii Akademii Medycznej w Gdańsku.
Wiad Lek. 2003;56(1-2):79-81.
The 8-year-old boy with 13 months history of enlargement of right cervical lymph nodes is described in this paper. Infectious lymphadenopathy was initially diagnosed. He was treated with antibiotics without success. Fine-needle aspiration biopsy in one of the enlarged lymph nodes showed the cells of normal thyroid gland without any signs of atypical growth. USG and scintigraphy revealed normal thyroid gland without nodules; no extra thyroid glands were detected. In 13th month of the disease two enlarged (about 5 ml each), painful, rather hard cervical nodules were present. The thyroid gland was no enlarged and without any palpable nodules. Chest X-ray and second thyroid scintigraphy were normal. Ultrasound imaging of thyroid gland revealed hypoechogenic lesion 11 x 9 x 12 in diameter in the upper part of right thyroid lobe. The morphological findings of removed nodules allowed to make a diagnosis of carcinoma papillare psammomatosum glandulae thyroideae. Total thyroidectomy with removal of cervical ipsilateral lymph nodes was performed. The operation is to be followed by radioactive iodine ablation and thyroid hormone suppression. The authors analyzed the causes and difficulties in diagnosis.
本文描述了一名8岁男孩，其右侧颈部淋巴结肿大已有13个月病史。最初诊断为感染性淋巴结病。他接受了抗生素治疗，但未成功。对其中一个肿大淋巴结进行细针穿刺活检，结果显示为正常甲状腺细胞，无任何非典型生长迹象。超声检查（USG）和闪烁扫描显示甲状腺正常，无结节；未检测到额外的甲状腺。在患病第13个月时，出现了两个肿大（每个约5毫升）、疼痛、质地较硬的颈部结节。甲状腺未肿大，未触及任何结节。胸部X线检查和第二次甲状腺闪烁扫描均正常。甲状腺超声成像显示右侧甲状腺叶上部有一个直径为11×9×12的低回声病变。切除结节的形态学检查结果确诊为甲状腺乳头状砂粒体癌。实施了全甲状腺切除术并切除同侧颈部淋巴结。术后将进行放射性碘消融和甲状腺激素抑制治疗。作者分析了诊断的原因及困难。
