Xue Nianyu, Xu Youfeng, Huang Pintong, Zhang Shengmin, Wang Hongwei, Yu Fei
Department of Ultrasonography, The Ningbo First Hospital, Ningbo, Zhejiang 315010, P.R. China.
Department of Ultrasonography, The Second Affiliated Hospital of Zhejiang University Medical College, Hangzhou, Zhejiang 310000, P.R. China.
Mol Clin Oncol. 2016 Aug;5(2):333-336. doi: 10.3892/mco.2016.932. Epub 2016 Jun 13.
The present study aimed to report the shear wave elastography (SWE) findings in a patient with the diffuse sclerosing variant of papillary thyroid carcinoma (DSVPTC). Since patients with DSVPTC may present with typical clinicopathological features and initially appear to have Hashimoto's thyroiditis, a thorough clinical evaluation and an early diagnosis are important. A 20-year-old female patient presented with a 1-month history of a neck mass and sore throat. Conventional ultrasound and SWE were performed using an AIXPLORER system with 14-5 MHz linear transducer. The patient had undergone total thyroidectomy and bilateral neck lymph node dissection, and an intraoperative pathology consultation to confirm the malignancy of lymph node metastasis. Pathological diagnosis was DSVPTC in both lobes, with lymph node metastases in the bilateral neck. The clinical presentation and serological findings were all indicative of Hashimoto's thyroiditis. Thyroid ultrasonography revealed diffuse enlargement of the both lobes, heterogenous echogenicity without mass formation, diffuse scattered microcalcifications and poor vascularization. SWE revealed stiff values of the thyroid: The mean stiffness was 99.7 kpa, the minimum stiffness was 59.1 kpa and the maximum stiffness was 180.1 kpa. The maximum stiffness of the DSVPTC (180.1 kpa) was higher compared with the diagnostic criteria of malignant thyroid nodules (65 kPa). SWE may be considered as a novel and valuable method to diagnose DSVPC.
本研究旨在报告1例弥漫性硬化型乳头状甲状腺癌（DSVPTC）患者的剪切波弹性成像（SWE）结果。由于DSVPTC患者可能具有典型的临床病理特征，最初看似患有桥本甲状腺炎，因此进行全面的临床评估和早期诊断很重要。1例20岁女性患者，有1个月颈部肿块和咽痛病史。使用配备14-5 MHz线性探头的AIXPLORER系统进行常规超声和SWE检查。患者接受了全甲状腺切除术和双侧颈部淋巴结清扫术，并进行了术中病理会诊以确认淋巴结转移的恶性程度。病理诊断为双侧叶DSVPTC，伴有双侧颈部淋巴结转移。临床表现和血清学检查结果均提示桥本甲状腺炎。甲状腺超声显示双侧叶弥漫性肿大，回声不均匀，无肿块形成，弥漫性散在微钙化，血管化差。SWE显示甲状腺硬度值：平均硬度为99.7 kpa，最小硬度为59.1 kpa，最大硬度为180.1 kpa。DSVPTC的最大硬度（180.1 kpa）高于甲状腺恶性结节的诊断标准（65 kPa）。SWE可被视为诊断DSVPC的一种新颖且有价值的方法。
