Laurent Silvana, Mouthon Luc, Longchampt Elisabeth, Roudaire Marie, Franc Sylvia, Krivitzky Alain, Cohen Régis
Internal Medicine and Endocrinology Unit, University Paris XIII and Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, 93009 Bobigny, France.
J Clin Endocrinol Metab. 2004 Apr;89(4):1534-7. doi: 10.1210/jc.2003-031355.
Plasma cell granuloma (PCG) is a rare, benign inflammatory tumor composed of myofibroblasts, abundant plasma cells, and lymphocytes combined with collagen. A thyroid localization of PCG is extremely rare, and surgical therapy is indicated. We report the case of a 35-yr-old woman with a thyroid PCG, associated with Hashimoto's thyroiditis, that was responsible for tracheal compression. Surgery was performed, but the thyroid could not be removed because of the fibrotic process. The patient was treated with corticosteroids and immunosuppressive therapy. Dyspnea and dysphagia improved within 1 month, whereas thyroid volume returned to normal within 3 yr. We also review other reports of thyroid PCG in the literature and discuss the differential diagnosis and treatment. Although the use of immunosuppressive therapy has never been reported for thyroid PCG until now, this treatment may represent a good alternative to surgery in life-threatening, unresectable PCG.
浆细胞性肉芽肿（PCG）是一种罕见的良性炎性肿瘤，由肌成纤维细胞、丰富的浆细胞和淋巴细胞以及胶原组成。PCG发生于甲状腺极为罕见，手术治疗是其指征。我们报告一例35岁女性患有甲状腺PCG，与桥本甲状腺炎相关，导致气管受压。进行了手术，但由于纤维化过程无法切除甲状腺。患者接受了皮质类固醇和免疫抑制治疗。呼吸困难和吞咽困难在1个月内改善，而甲状腺体积在3年内恢复正常。我们还回顾了文献中其他甲状腺PCG的报道，并讨论了鉴别诊断和治疗。虽然迄今为止尚未有免疫抑制治疗用于甲状腺PCG的报道，但这种治疗可能是危及生命、无法切除的PCG手术的良好替代方案。
