Kodama T, Yashiro T, Ito Y, Obara T, Fujimoto Y, Kusakabe K, Hirayama A
Department of Endocrine Surgery, Tokyo Women's Medical College.
Endocrinol Jpn. 1987 Oct;34(5):779-84. doi: 10.1507/endocrj1954.34.779.
We report a 46-year-old male patient with a transient thyrotoxicosis that seems to have been caused by hemorrhagic infarction of a cold thyroid nodule. The serum level of triiodothyronine was markedly but transiently elevated, while the serum thyroxine level remained within the normal range. The resected nodule, measuring 8 x 7 x 5 cm, showed extensive degeneration and necrosis with viable follicles left only at the margin of the nodule. A transient thyrotoxicosis due to acute hemorrhagic infarction of autonomously functioning thyroid nodules has already been reported. This case showed that the phenomenon could occur even in cold thyroid nodules. Its implications were discussed in relation to the high incidence of impaired TSH response to TRH in patients with nodular goiter.
我们报告了一名46岁男性患者，其患有短暂性甲状腺毒症，似乎是由冷甲状腺结节的出血性梗死所致。血清三碘甲状腺原氨酸水平显著但短暂升高，而血清甲状腺素水平仍在正常范围内。切除的结节大小为8×7×5厘米，显示广泛的变性和坏死，仅在结节边缘留有存活的滤泡。自主功能性甲状腺结节急性出血性梗死导致的短暂性甲状腺毒症已有报道。该病例表明，这种现象甚至可发生在冷甲状腺结节中。结合结节性甲状腺肿患者促甲状腺激素对促甲状腺激素释放激素反应受损的高发生率，对其意义进行了讨论。
