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一例经胸腔镜切除的纵隔甲状旁腺囊肿病例。

A thoracoscopically resected case of mediastinal parathyroid cyst.

作者信息

Takashima Seiki, Nakano Hideharu, Minamoto Kanji, Misao Takahiko, Shiota Kunihiko

机构信息

Department of Surgery, Kagawa Prefectural Central Hospital, Takamatsu,, Japan.

出版信息

Acta Med Okayama. 2005 Aug;59(4):165-70. doi: 10.18926/AMO/31954.

Abstract

A 67-year-old male visited his physician because of a 2-month history of cough and sputum. An abnormal shadow at the left upper mediastinum on chest x-ray film was detected, and the patient was referred to our department for further examination. Chest x-ray film revealed a round shadow at the left upper posterior mediastinum. Computed tomography(CT)revealed a uniform iso density mass about 4 cm in diameter, with a well-defined border. After the intravenous contrast administration, a slight peripheral enhancement was seen around the mass. On magnetic resonance imaging, the mass was hypointense in T1-weighting and hyperintense in T2-weighting. The contrast pattern was the same as that observed in the CT scan. On sagittal and coronal sections, the mass was adjacent to the aortic arch. Although a benign tumor was mostly suspected based on imaging findings, a malignant tumor was also possible. Accordingly, we resected this mass with video-assisted thoracoscopy. Findings at operation were a cystic mass. The pathological findings were compatible with benign parathyroid cyst, which was suspected to be the cystic degeneration of a parathyroid adenoma.

摘要

一名67岁男性因咳嗽、咳痰2个月前往就医。胸部X线片发现左上纵隔有异常阴影,患者被转诊至我科进一步检查。胸部X线片显示左上后纵隔有一圆形阴影。计算机断层扫描(CT)显示一个直径约4厘米的均匀等密度肿块,边界清晰。静脉注射造影剂后,肿块周围可见轻微的周边强化。在磁共振成像上,肿块在T1加权像上呈低信号,在T2加权像上呈高信号。造影模式与CT扫描所见相同。在矢状面和冠状面上,肿块与主动脉弓相邻。尽管根据影像学表现大多怀疑为良性肿瘤,但也有可能是恶性肿瘤。因此,我们通过电视辅助胸腔镜切除了这个肿块。手术所见为囊性肿块。病理结果与良性甲状旁腺囊肿相符,怀疑是甲状旁腺腺瘤的囊性变。

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