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1例甲状腺舌管囊肿内的乳头状癌,甲状腺内无癌。

A case of papillary carcinoma in a thyroglossal cyst without a carcinoma in the thyroid gland.

作者信息

Albayrak Yavuz, Albayrak Fatih, Kaya Zülküf, Kabalar Esref, Aylu Belkiz

机构信息

Department of General Surgery and Burn Unit, Erzurum Region Education and Research Hospital, Erzurum, Turkey.

出版信息

Diagn Cytopathol. 2011 Jan;39(1):38-41. doi: 10.1002/dc.21356.

Abstract

The thyroglossal duct cyst is the most common developmental anomaly of the thyroid gland. We present a patient with a papillary thyroid carcinoma diagnosed after surgical resection of a thyroglossal cyst. The 39-year-old patient reported to our hospital due to a swelling of this throat. The results of the ultrasonography were reported as showing multiple nodules in both thyroid lobes, and an ~3-cm diameter image in the submental area, in keeping with lymphadenomegalia. In the fine-needle aspiration cytology (FNAC) evaluation from the nodules in the thyroid, it was observed that the thyrocites with uniform nuclei made up single-layer groups. FNAC from the thyroglossal cyst, a few histiocytes were observed on a ground with a large number of erythrocytes. The patient was subjected to a total thyroidectomy, pyramidal lobe excision, and total excision of the 3-cm diameter soft mass, starting at the tip of the pyramidal lobe. The case was diagnosed as papillary thyroid carcinoma in thyroglossal duct cyst with histopathological and immunohistochemical findings. If the thyroglossal channel cyst had been diagnosed preoperatively, total thyroidectomy and a Sistrunk operation would have been performed. For this reason, repeated FNAC, particularly, if performed under ultrasound guidance, may improve the diagnostic value of FNAC. Thus, in such patients, throat ultrasonography must be carried out in expert hands, thin-needle aspiration biopsy, computerized tomography, and thyroid scintigraphy must be done if necessary, and the necessary treatment protocols carried out after a definite diagnosis.

摘要

甲状舌管囊肿是甲状腺最常见的发育异常。我们报告一例患者,在甲状舌管囊肿手术切除后诊断为甲状腺乳头状癌。该39岁患者因喉部肿胀到我院就诊。超声检查结果报告显示双侧甲状腺叶有多个结节,颏下区域有一个直径约3 cm的影像,符合淋巴结肿大。在对甲状腺结节进行细针穿刺细胞学检查(FNAC)时,观察到细胞核均匀的甲状腺细胞组成单层细胞群。对甲状舌管囊肿进行FNAC检查时,在大量红细胞背景上观察到一些组织细胞。患者接受了全甲状腺切除术、锥体叶切除术以及从锥体叶尖端开始对直径3 cm的软组织肿块进行完整切除。根据组织病理学和免疫组化结果,该病例被诊断为甲状舌管囊肿内的甲状腺乳头状癌。如果术前诊断出甲状舌管囊肿,本应进行全甲状腺切除术和Sistrunk手术。因此,重复进行FNAC检查,特别是在超声引导下进行,可能会提高FNAC的诊断价值。因此,对于此类患者,必须由专业人员进行喉部超声检查,必要时进行细针穿刺活检、计算机断层扫描和甲状腺闪烁显像,并在明确诊断后实施必要的治疗方案。

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