Miyazaki Megumi, Okada Yosuke, Torimoto Keiichi, Tanaka Yoshiya
First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
J UOEH. 2019;41(2):165-170. doi: 10.7888/juoeh.41.165.
A 74-year-old woman with a left neck mass and thyrotoxicosis was referred to our hospital, and was later diagnosed with Marine-Lenhart syndrome based on positivity for thyroid autoantibodies, ultrasonographically evident left lobe thyroid nodule with increased blood flow, and scintigraphically identified not only increased tumor-like accumulation but also diffused uptake. Disease control was difficult despite administration of antithyroid drugs, so subtotal thyroidectomy was performed. No hyperplastic changes or histopathological findings characteristic of Graves disease were evident on histopathology, so Plummer disease was considered to be dominant. In case of hot in low type which showed higher uptake in the nodule and lower uptake in the extranodular part on scintigraphy, there is a possibility of relapse in drug treatment.
一名74岁女性因左侧颈部肿块和甲状腺毒症转诊至我院，随后根据甲状腺自身抗体阳性、超声显示左侧叶甲状腺结节且血流增加、闪烁扫描不仅发现肿瘤样积聚增加而且有弥漫性摄取，被诊断为Marine-Lenhart综合征。尽管使用了抗甲状腺药物，但疾病控制困难，因此进行了甲状腺次全切除术。组织病理学检查未发现Graves病典型的增生性改变或组织病理学特征，因此认为以Plummer病为主。对于闪烁扫描显示结节摄取较高而结节外部分摄取较低的热低型病例，药物治疗有复发的可能性。
