Camargos Einstein Francisco, Pandolfi Marcela Basso, Toledo Maria Alice V, Quintas Juliana Lima, Moreira Sebastião, de Azevedo Ana Emília Borges, Tavares Alexandre Cavalca
Geriatric Medical Centre, University Hospital, Brasilia University, Brasilia, Brazil.
BMJ Case Rep. 2010 Aug 31;2010:2823. doi: 10.1136/bcr.03.2010.2823.
A 95-year-old woman had been treated over the past 8 years for progressive dysphagia. When her condition worsened, blood tests revealed the presence of leucocytosis and eosinophilia in the absence of anaemia or thrombocytopenia. Within 11 days of diagnosis, the patient died of respiratory failure. Necropsy showed normal thyroid tissue and an absence of infectious disease. However, an upper mediastinal tumour was found and was histopathologically diagnosed as a neoplastic transformation of the ectopic thyroid. Only 1% of endothoracic goitres present as ectopic or autonomous goitre with no parenchymal or vascular connection to the thyroid gland. This case represents a very rare situation in which a leukemoid reaction and peripheral hypereosinophilia were observed as a manifestation of an anaplastic thyroid carcinoma in an ectopic mass.
一名95岁女性在过去8年中一直因进行性吞咽困难接受治疗。当她的病情恶化时，血液检查显示存在白细胞增多和嗜酸性粒细胞增多，而无贫血或血小板减少。在诊断后的11天内，患者死于呼吸衰竭。尸检显示甲状腺组织正常，无传染病。然而，发现了一个上纵隔肿瘤，经组织病理学诊断为异位甲状腺的肿瘤性转化。只有1%的胸内甲状腺肿表现为异位或自主性甲状腺肿，与甲状腺无实质或血管连接。本病例代表了一种非常罕见的情况，即异位肿块中的间变性甲状腺癌表现为类白血病反应和外周嗜酸性粒细胞增多。
