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皮肤窦道形成是甲状腺细针穿刺活检的一种罕见并发症。

Cutaneous sinus formation is a rare complication of thyroid fine needle aspiration biopsy.

作者信息

Akbaba Gülhan, Omar Muhyettin, Polat Murat, Özcan Önder, Bellı Ahmet Korkut, Şahan Murat, Çullu Neşat

机构信息

Department of Endocrinology and Metabolism Diseases, Faculty of Medicine, Muğla Sıtkı Koçman University, 48000 Mugla, Turkey.

Department of Internal Medicine, Faculty of Medicine, Muğla Sıtkı Koçman University, 48000 Mugla, Turkey.

出版信息

Case Rep Endocrinol. 2014;2014:923438. doi: 10.1155/2014/923438. Epub 2014 Dec 8.

Abstract

Fine needle aspiration biopsy (FNAB) is essential in the diagnosis and management of thyroid nodules. In this paper, we report a rare complication, cutaneous sinus formation, after diagnostic FNAB guided by palpation. Sixty-three-year-old female patient was admitted with the complaints of hoarseness and discharge from the anterior neck wall which were present for the last 6 months. The patient underwent a near total thyroidectomy 17 years ago. Recurrent nodular goiter was detected six months before and a diagnostic FNAB guided by palpation was performed. Two weeks later the patient had wound discharge and hoarseness. Physical examination of the patient revealed a sinus, which was located superior to the thyroidectomy incision. A 1 cm nodule was palpated in the left side of her neck. A cervical ultrasonography (USG) showed a 9 × 7 mm nodule in the remnant thyroid and a 9.5 × 3.5 mm fistulized fluid collection. The patient underwent sinus tract and remnant thyroid removal. This case report presents a cutaneous sinus formation deriving from the granulation tissue, probably due to the silk suture reaction in the previous surgery, by the FNAB guided by palpation procedure. We suggest USG guided FNAB to achieve more accurate and safe diagnosis in evaluating the thyroid nodules.

摘要

细针穿刺活检(FNAB)在甲状腺结节的诊断和处理中至关重要。在本文中,我们报告了1例触诊引导下诊断性FNAB术后罕见的并发症——皮肤窦道形成。1例63岁女性患者,因近6个月来出现声音嘶哑和颈前壁溢液而入院。该患者17年前接受了近全甲状腺切除术。6个月前检测到复发性结节性甲状腺肿,并进行了触诊引导下的诊断性FNAB。两周后,患者出现伤口渗液和声音嘶哑。体格检查发现患者有一个位于甲状腺切除术后切口上方的窦道。在其颈部左侧可触及一个1 cm的结节。颈部超声检查(USG)显示残余甲状腺内有一个9×7 mm的结节以及一个9.5×3.5 mm的瘘管样液性聚集区。患者接受了窦道和残余甲状腺切除术。本病例报告展示了1例由肉芽组织形成的皮肤窦道,可能是由于既往手术中丝线缝合反应所致,该窦道由触诊引导下的FNAB操作引起。我们建议采用USG引导下的FNAB,以在评估甲状腺结节时实现更准确、安全的诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65ea/4274850/d3e56aaca9ad/CRIE2014-923438.001.jpg

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