Theurer S, Siebolts U, Lorenz K, Dralle H, Schmid K W
Institut für Pathologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland.
Institut für Pathologie, Universitätsklinikum Halle, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland.
Pathologe. 2018 Sep;39(5):379-389. doi: 10.1007/s00292-018-0467-1.
Ectopic thyroid tissue results from developmental defects of the early stages of thyroid embryogenesis, in which the median thyroid anlage descends from the floor of the mouth to its final pre-tracheal position. The most common sites of ectopic thyroid tissue are accordingly in the area of the floor of the mouth and in the course of the thyroglossal duct. Rare localizations are intrathoracic (mediastinal, cardiac, pulmonary) and sub-diaphragmatic (including the adrenals, liver, gall bladder, and gastrointestinal tract). The most important differential diagnosis of ectopic thyroid is metastasis of differentiated thyroid carcinoma.By contrast, the term parathyroidectopy is not uniformly defined. Usually, the cervical-central localizations are referred to as "positional variants" (with the exception of the maxillary sinus and high parapharyngeal), whereas the cervical-lateral localizations (carotid sheath, vagus nerve) and those below the brachiocephalic and mediastinal positions (extraligamentary, aortopulmonary window, paravagal) and other rare localizations are classified as "ectopic parathyroid tissue". Parathyroidectomy is very common (in autopsy studies in 28 to 42.8% of all humans). In the context of primary hyperparathyroidism (pHPT), there is a prevalence of 6.3 to 16% of ectopic hyperfunctional parathyroid tissue (predominantly adenomas), which play an important role in the surgical treatment of pHPT.
异位甲状腺组织源于甲状腺胚胎发育早期的发育缺陷,在此过程中,甲状腺原基从口腔底部下降至其最终的气管前位置。因此,异位甲状腺组织最常见的部位是口腔底部区域和甲状舌管走行部位。罕见的部位包括胸腔内(纵隔、心脏、肺)和膈下(包括肾上腺、肝脏、胆囊和胃肠道)。异位甲状腺最重要的鉴别诊断是分化型甲状腺癌的转移。相比之下,甲状旁腺异位的定义并不统一。通常,颈部中央部位的甲状旁腺被称为“位置变异”(上颌窦和咽旁高位除外),而颈部外侧部位(颈动脉鞘、迷走神经)以及头臂干和纵隔位置以下的部位(韧带外、主肺动脉窗、迷走神经旁)和其他罕见部位则被归类为“异位甲状旁腺组织”。甲状旁腺切除术非常常见(在尸检研究中,占所有人的28%至42.8%)。在原发性甲状旁腺功能亢进症(pHPT)的情况下,异位功能性甲状旁腺组织(主要是腺瘤)的患病率为6.3%至16%,这在pHPT的手术治疗中起着重要作用。