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同一淋巴结内伴有颈内静脉血栓的分化型甲状腺癌转移和慢性淋巴细胞白血病的同时发生:一例报告。

Concomittant occurence of well-differentiated thyroid carcinoma metastasis and chronic lymphocytic leukemia in the same lymph node along with internal jugular vein thrombus: a case report.

机构信息

Department of Medicine, Division of Endocrinology, Koc University School of Medicine, Istanbul, Turkey.

Department of Medicine, Division of General Surgery, American Hospital, Istanbul, Turkey.

出版信息

Indian J Pathol Microbiol. 2021 Jan-Mar;64(1):149-151. doi: 10.4103/IJPM.IJPM_537_20.

Abstract

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is the most common adult leukemia. The coexistence of CLL and papillary thyroid carcinoma (PTC) is extremely rare. PTC sometimes shows microscopic vascular invasion but rarely cause a tumor thrombus in the internal jugular vein (IJV). It is also rare to find both differentiated and poorly differentiated types of thyroid cancer in the same metastatic location. We report a case of 63-year-old Turkish man with history of CLL who had CLL/SLL involvement and PTC metastasis in the same lymph node. Additionally, there was macroscopic metastasis to the IJV with poorly differentiated areas in the removed tumor thrombus. Patient was treated with total thyroidectomy, left radical neck dissection, resection of the left IJV segment that contained the tumor thrombus and radioactive iodine (RAI) therapy. Furthermore, metastatic lesions were found in the brain, lung and bone. Radiotherapy and chemotherapy were performed. However, our patient died approximately 12 months after thyroidectomy. To our knowledge, our present report is the first description with its current features.

摘要

慢性淋巴细胞白血病/小淋巴细胞淋巴瘤(CLL/SLL)是最常见的成人白血病。CLL 与甲状腺乳头状癌(PTC)共存极为罕见。PTC 有时表现为镜下血管侵犯,但很少在内颈静脉(IJV)形成肿瘤血栓。在同一转移部位发现分化型和未分化型甲状腺癌也很少见。我们报告了一例 63 岁土耳其男性,患有 CLL,同一淋巴结中存在 CLL/SLL 浸润和 PTC 转移。此外,在切除的肿瘤血栓中有肉眼可见的转移至 IJV,并伴有未分化区域。患者接受了甲状腺全切除术、左侧根治性颈淋巴结清扫术、包含肿瘤血栓的左侧 IJV 段切除术和放射性碘(RAI)治疗。此外,还在脑部、肺部和骨骼中发现了转移性病变。进行了放疗和化疗。然而,我们的患者在甲状腺切除术后约 12 个月死亡。据我们所知,目前的报告是首次对其进行描述。

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