Führer D, Schmid K W
Klinik für Endokrinologie und Nephrologie,Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig, Liebigstrasse 18, 04103, Leipzig, Deutschland.
Internist (Berl). 2010 May;51(5):611-9. doi: 10.1007/s00108-009-2500-1.
Thyroid nodular disease is highly frequent and affects 20-23% of the adult population in Germany. Differential diagnosis of thyroid nodules is directed at exclusion of thyroid autonomy and thyroid cancer. In addition, large nodules/nodular goiters may cause oesophageal and/or tracheal compression. Besides the patient's history and clinical examination, laboratory investigations (TSH-level, calcitonin screening), functional (scintiscan) and morphological imaging (ultrasound, in rare cases also CT without contrast media and MRI), as well as fine needle aspiration biopsy are useful tools in the differential diagnosis. In the past years, major advances have been made in the understanding of the molecular pathogenesis of thyroid tumors. This has led to the possibility of a molecular classification of thyroid tumors and may have prognostic as well as therapeutic impact.
甲状腺结节性疾病极为常见，在德国影响着20%至23%的成年人口。甲状腺结节的鉴别诊断旨在排除甲状腺自主性和甲状腺癌。此外，大的结节/结节性甲状腺肿可能会导致食管和/或气管受压。除了患者病史和临床检查外，实验室检查（促甲状腺激素水平、降钙素筛查）、功能检查（闪烁扫描）和形态学成像（超声，极少数情况下也包括无造影剂的CT和MRI）以及细针穿刺活检都是鉴别诊断的有用工具。在过去几年中，对甲状腺肿瘤分子发病机制的认识取得了重大进展。这使得对甲状腺肿瘤进行分子分类成为可能，并且可能对预后和治疗产生影响。
