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桥本甲状腺炎相关的颈部淋巴结病:22例细针穿刺细胞学分析

Cervical lymphadenopathy associated with Hashimoto's thyroiditis: an analysis of 22 cases by fine needle aspiration cytology.

作者信息

Paksoy Nadir, Yazal Kadri

机构信息

Paksoy's Cytopathology Laboratory, Izmit, Kocaeli, Turkey.

出版信息

Acta Cytol. 2009 Sep-Oct;53(5):491-6. doi: 10.1159/000325374.

Abstract

OBJECTIVE

To analyze the possible association between Hashimoto's thyroiditis (HT) and cervical lymphadenopathy in cases diagnosed by fine needle aspiration cytology.

STUDY DESIGN

Among the patients referred to our laboratory for ultrasound-guided fine needle aspiration cytology of thyroid nodules (USG-FNAC), cases of HT associated with cervical lymphadenopathy were evaluated.

RESULTS

Between February 2001 and May 2007, HT was diagnosed in 94 (11%) of a total of 856 thyroid USG-FNAC cases. Among these cases, 22 (23%) were associated with single/ multiple cervical lymphadenopathy. In all cases, FNAC of the lymph nodes was consistent with reactive lymphoid hyperplasia. Anti-TPO and anti-Tg antibody results were obtained in 14 of 22 cases with HT. Among these cases, 12 showed positive values.

CONCLUSION

Clinicians and cytopathologists who encounter thyroid nodules with cervical lymphadenopathy should also include the possibility of HT in the differential diagnosis. A literature search disclosed no report regarding the possible association between HT and cervical lymphadenopathy. Considering the limitations due to lack of immunocytochemical analysis of the thyroid and lymph node aspirates, our study should be taken as a preliminary one.

摘要

目的

分析经细针穿刺细胞学诊断的病例中桥本甲状腺炎(HT)与颈部淋巴结病之间可能存在的关联。

研究设计

在转诊至我们实验室进行甲状腺结节超声引导下细针穿刺细胞学检查(USG-FNAC)的患者中,对伴有颈部淋巴结病的HT病例进行评估。

结果

在2001年2月至2007年5月期间,856例甲状腺USG-FNAC病例中,94例(11%)被诊断为HT。在这些病例中,22例(23%)伴有单个/多个颈部淋巴结病。所有病例中,淋巴结的FNAC结果均符合反应性淋巴样增生。22例HT病例中有14例获得了抗甲状腺过氧化物酶(Anti-TPO)和抗甲状腺球蛋白(Anti-Tg)抗体结果。其中12例呈阳性。

结论

遇到伴有颈部淋巴结病的甲状腺结节的临床医生和细胞病理学家在鉴别诊断中也应考虑HT的可能性。文献检索未发现关于HT与颈部淋巴结病之间可能关联的报道。鉴于甲状腺和淋巴结抽吸物缺乏免疫细胞化学分析存在局限性,本研究应视为初步研究。

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