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一名甲状腺乳头状癌患者肺叶切除术后发生亚急性淋巴细胞性甲状腺炎：病例报告

Subacute lymphocytic thyroiditis after lobectomy in a patient with papillary thyroid carcinoma: a case report.

作者信息

Choi Young Sik, Han You Jin, Yeo Go Eun, Kwon Su Kyoung, Kim Bu Kyung, Park Yo-Han, Kim Sung Won, Chun Bong Kwon, Kong Eun Hee, Kim Jeong Hoon

机构信息

Department of Internal Medicine, Kosin University College of Medicine, 262 Gamcheon Street SeoGu, Busan, 602-703, South Korea.

出版信息

J Med Case Rep. 2013 Jan 3;7:3. doi: 10.1186/1752-1947-7-3.

DOI:10.1186/1752-1947-7-3
PMID:23286248
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3552870/
Abstract

INTRODUCTION

Subacute lymphocytic thyroiditis is anautoimmune thyroid disease presenting with transient thyrotoxicosis as well as transient hypothyroidism. Several factors have been thought to be the initiating event in subacute lymphocytic thyroiditis. However, subacute lymphocytic thyroiditis that develops after thyroid lobectomy has not yet been reported in the literature. We report a case of subacute lymphocytic thyroiditis after lobectomy in a patient with papillary thyroid carcinoma.

CASE PRESENTATION

A 30-year-old Korean woman was referred to our center for thyroid tumor operation. She was diagnosed with suspicious papillary thyroid carcinoma by fine needle aspiration at a local medical clinic. The thyroid ultrasonography demonstrated a diffusely enlarged thyroid gland with a 0.4×0.3cm sized hypoechoic nodule in the left lobe. Left thyroid lobectomy by endoscopic thyroidectomy was performed via a transaxillary approach, and the nodule was confirmed to be a papillary thyroid carcinoma. On postoperative day 1, a thyroid function test revealed hyperthyroidism, and on postoperative day 8, a thyroid function test again revealed hyperthyroidism with decreased radioactive iodine uptake. Thyroid function tests showed euthyroid on postoperative day 48 and hypothyroidism on postoperative day 86. She was treated with levothyroxine.

CONCLUSION

Subacute lymphocytic thyroiditis can develop after thyroid lobectomy. Thyroid autoantigen released during thyroid lobectomy may cause the onset or exacerbation of the destructive process.

摘要

引言

亚急性淋巴细胞性甲状腺炎是一种自身免疫性甲状腺疾病，表现为短暂性甲状腺毒症以及短暂性甲状腺功能减退。多种因素被认为是亚急性淋巴细胞性甲状腺炎的起始事件。然而，甲状腺叶切除术后发生的亚急性淋巴细胞性甲状腺炎在文献中尚未见报道。我们报告一例甲状腺乳头状癌患者甲状腺叶切除术后发生亚急性淋巴细胞性甲状腺炎的病例。

病例介绍

一名30岁的韩国女性因甲状腺肿瘤手术被转诊至我们中心。她在当地一家诊所通过细针穿刺被诊断为可疑甲状腺乳头状癌。甲状腺超声显示甲状腺弥漫性肿大，左叶有一个0.4×0.3cm大小的低回声结节。通过经腋窝入路行内镜下甲状腺左叶切除术，结节被确诊为甲状腺乳头状癌。术后第1天，甲状腺功能检查显示甲状腺功能亢进，术后第8天，甲状腺功能检查再次显示甲状腺功能亢进且放射性碘摄取降低。术后第48天甲状腺功能检查显示甲状腺功能正常，术后第86天显示甲状腺功能减退。她接受了左甲状腺素治疗。

结论

甲状腺叶切除术后可发生亚急性淋巴细胞性甲状腺炎。甲状腺叶切除术中释放的甲状腺自身抗原可能导致破坏性过程的发生或加重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75a5/3552870/76bd1dd8b8cb/1752-1947-7-3-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75a5/3552870/7d9f569506a4/1752-1947-7-3-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75a5/3552870/922df8b86ad5/1752-1947-7-3-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75a5/3552870/76bd1dd8b8cb/1752-1947-7-3-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75a5/3552870/7d9f569506a4/1752-1947-7-3-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75a5/3552870/922df8b86ad5/1752-1947-7-3-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75a5/3552870/76bd1dd8b8cb/1752-1947-7-3-3.jpg

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