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肝门部异位甲状腺的影像学见解:一例报告并文献复习

Radiological insights of ectopic thyroid in the porta hepatis: A case report and review of the literature.

作者信息

Chooah Outesh, Ding Jing, Fei Jing-Le, Xu Fang-Yi, Yue Ting, Pu Cai-Ling, Hu Hong-Jie

机构信息

Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.

出版信息

World J Clin Cases. 2021 May 16;9(14):3432-3441. doi: 10.12998/wjcc.v9.i14.3432.

Abstract

BACKGROUND

Ectopic thyroid is defined as a rare developmental anomaly where thyroid tissues are atypically found in locations other than its normal anatomical position: Anterolateral to the second, third, and fourth tracheal cartilages. An intemperate descent or a migration failure of the thyroid anlage results in sub-diaphragmatic thyroid ectopia, a sparse clinical entity.

CASE SUMMARY

This case portrays a 63-year-old female patient presenting with chronic abdominal discomfort at a local hospital whereby a computed tomography (CT) scan revealed a well-defined mass in the hepatic entrance. For further examination, the patient underwent a CT scan with contrast, magnetic resonance imaging (MRI), and CT-angiography (CTA) at our department. The CT scan showed a well-defined and high attenuated mass measuring 43 mm × 38 mm in the hepatic entrance with calcification. The CTA revealed an additional finding: Blood supply to the mass from the right hepatic artery. MRI of the upper abdomen demonstrated a mass with mixed signal intensity on T1 and T2 weighted images in the hepatic entrance. The patient underwent surgery with resection of the mass which was sent for histopathology. Ectopic thyroid at the level of porta hepatis with nodules was the definitive diagnosis since histopathological report revealed presence of thyroid tissue in the resected liver mass.

CONCLUSION

This case delivers a rare insight of pre-operative radiological imaging of an ectopic thyroid located in the liver. These findings can aid in narrowing down potential differential diagnosis when managing a patient with those subsequent findings.

摘要

背景

异位甲状腺被定义为一种罕见的发育异常,即甲状腺组织在其正常解剖位置(气管第二、三、四软骨前外侧)以外的部位非典型出现。甲状腺原基的过度下降或迁移失败会导致膈下甲状腺异位,这是一种临床少见的情况。

病例摘要

本病例描述了一名63岁女性患者,在当地医院因慢性腹部不适就诊,计算机断层扫描(CT)显示肝门处有一个边界清晰的肿块。为进一步检查,患者在我院接受了增强CT扫描、磁共振成像(MRI)和CT血管造影(CTA)。CT扫描显示肝门处有一个边界清晰、高密度的肿块,大小为43mm×38mm,伴有钙化。CTA显示了另一个发现:肿块由右肝动脉供血。上腹部MRI显示肝门处的肿块在T1加权和T2加权图像上信号强度混合。患者接受了手术切除肿块,并将其送去做组织病理学检查。肝门处异位甲状腺伴结节是最终诊断,因为组织病理学报告显示切除的肝脏肿块中存在甲状腺组织。

结论

本病例提供了位于肝脏的异位甲状腺术前放射影像学的罕见见解。这些发现有助于在处理有这些后续发现的患者时缩小潜在的鉴别诊断范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fddd/8107913/25cf6ca66201/WJCC-9-3432-g001.jpg

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