一例伪装成甲状腺结节的颈部神经鞘瘤。
A Cervical Schwannoma Masquerading as a Thyroid Nodule.
作者信息
Nagavalli Sravanthi, Yehuda Marelle, McPhaul Laron W, Gianoukakis Andrew G
机构信息
Division of Endocrinology and Metabolism, Harbor-UCLA Medical Center, Torrance, CA, USA.
Department of Pathology and Laboratory Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA.
出版信息
Eur Thyroid J. 2017 Jul;6(4):216-220. doi: 10.1159/000454877. Epub 2017 Jan 21.
BACKGROUND
We present a case of a cervical schwannoma, likely originating from the pharyngeal plexus of the vagal nerve. The lesion masqueraded as a thyroid nodule and magnetic resonance imaging (MRI) assisted in preoperative diagnosis. We review the radiographic characteristics of nerve sheath tumors on MRI as well as the diagnostic cytologic stains which can enhance the possibility of a correct preoperative diagnosis.
CASE
We describe a 60-year-old female with dysphagia and a neck mass consistent with a nodular goiter. The patient's history, diagnostic images, cytology, pathology, and surgical management are presented and analyzed. The preoperative diagnosis of a cervical schwannoma was suspected by the use of MRI which led to additional specialized cytologic stains.
CONCLUSION
Pharyngeal wall schwannomas are important to consider in the differential diagnosis of thyroid nodules when fine needle aspiration cytology indicates cells of neural origin. Imaging by MRI can assist in identifying lesions of neural origin masquerading as thyroid nodules.
背景
我们报告一例颈神经鞘瘤病例，可能起源于迷走神经的咽丛。该病变伪装成甲状腺结节，磁共振成像（MRI）有助于术前诊断。我们回顾了神经鞘瘤在MRI上的影像学特征以及可提高术前正确诊断可能性的诊断性细胞学染色。
病例
我们描述了一名60岁女性，有吞咽困难和与结节性甲状腺肿一致的颈部肿块。呈现并分析了患者的病史、诊断图像、细胞学、病理学和手术治疗情况。通过MRI怀疑为颈神经鞘瘤的术前诊断，这促使进行了额外的专门细胞学染色。
结论
当细针穿刺细胞学显示为神经源性细胞时，在甲状腺结节的鉴别诊断中，咽壁神经鞘瘤是需要考虑的重要因素。MRI成像有助于识别伪装成甲状腺结节的神经源性病变。
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