Biddinger P W, Brennan M F, Rosen P P
Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021.
Am J Surg Pathol. 1991 Jun;15(6):599-604. doi: 10.1097/00000478-199106000-00009.
A 58-year-old euthyroid man with episodic flushing and a 2-year history of progressive wheezing was found to have a hypoechoic lesion in one lobe of his thyroid and hypercalcitoninemia in response to pentagastrin stimulation. Thyroidectomy revealed bilateral C-cell hyperplasia unexpectedly associated with chronic lymphocytic thyroiditis. The C-cells exhibited positive immunohistochemical staining for calcitonin and polyclonal carcinoembryonic antigen (CEA). Postoperatively, the wheezing and flushing subsided and the serum calcitonin level was not elevated with pentagastrin stimulation. The substance or substances responsible for the wheezing and flushing were not specifically identified. Nine other specimens of chronic lymphocytic thyroiditis were examined for C-cell hyperplasia and two had small hyperplastic foci, but of a lesser degree than the index case. These patients did not exhibit wheezing and flushing. The development of C-cell hyperplasia in chronic lymphocytic thyroiditis is uncommon and the mechanism for its occurrence is unexplained. This patient appears to be the first reported case of symptomatic C-cell hyperplasia associated with chronic lymphocytic thyroiditis. The substance or substances responsible for the clinical symptoms remain to be identified.
一名58岁甲状腺功能正常的男性，有发作性潮红病史，并伴有进行性喘息2年，在其甲状腺的一个叶中发现低回声病变，且在五肽胃泌素刺激下出现降钙素血症。甲状腺切除术意外发现双侧C细胞增生，并伴有慢性淋巴细胞性甲状腺炎。C细胞降钙素和多克隆癌胚抗原（CEA）免疫组化染色呈阳性。术后，喘息和潮红消退，五肽胃泌素刺激下血清降钙素水平未升高。导致喘息和潮红的物质未被明确鉴定。对另外9例慢性淋巴细胞性甲状腺炎标本进行了C细胞增生检查，其中2例有小的增生灶，但程度低于该病例。这些患者未出现喘息和潮红。慢性淋巴细胞性甲状腺炎中C细胞增生的发生并不常见，其发生机制尚不清楚。该患者似乎是首例有症状的与慢性淋巴细胞性甲状腺炎相关的C细胞增生报告病例。导致临床症状的物质仍有待确定。
