Department of Internal Medicine, Research Center for Endocrine and Metabolic Diseases, School of Medicine, Chungnam National University, Daejeon, South Korea.
Eur Arch Otorhinolaryngol. 2014 Feb;271(2):417-20. doi: 10.1007/s00405-013-2777-5. Epub 2013 Oct 23.
Amyloid accumulation in the thyroid gland leading to a clinically detectable mass, known as amyloid goiter, is a rare condition associated with primary amyloidosis. Moreover, a localized primary amyloid goiter involving only the thyroid gland is rarer still. Here, we report a patient with a localized primary amyloid goiter that had grown rapidly, causing dysphagia and dyspnea on exercise, and confused us with malignancy such as anaplastic carcinoma. After surgery, no further symptoms occurred. A diagnosis of amyloid goiter was established on microscopic examination. In patients with a rapidly enlarging thyroid gland presenting with dysphagia, dyspnea, or hoarseness, amyloid goiter and malignancy should both be suspected, even when systemic amyloidosis is not suspected.
甲状腺内的淀粉样物质积累导致临床上可检测到的肿块,称为淀粉样甲状腺肿,是一种与原发性淀粉样变性相关的罕见疾病。此外,仅累及甲状腺的局部原发性淀粉样甲状腺肿更为罕见。在这里,我们报告了一例局部原发性淀粉样甲状腺肿患者,其肿瘤迅速生长,导致吞咽困难和运动时呼吸困难,并使我们与恶性肿瘤(如间变性癌)相混淆。手术后,患者未再出现其他症状。显微镜检查诊断为淀粉样甲状腺肿。对于出现吞咽困难、呼吸困难或声音嘶哑且甲状腺迅速增大的患者,即使不怀疑系统性淀粉样变性,也应怀疑为淀粉样甲状腺肿和恶性肿瘤。