病例报告：伴有多发颈部淋巴结转移的大滤泡性甲状腺癌。
Case report: Large follicular thyroid carcinoma with multiple cervical lymph node metastases.
作者信息
Ye Fei, Liao Liyan, Tan Wanlin, Gong Yi, Li Xiaodu, Niu Chengcheng
机构信息
Department of Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, China.
出版信息
Front Surg. 2022 Aug 23;9:995859. doi: 10.3389/fsurg.2022.995859. eCollection 2022.
INTRODUCTION
Follicular thyroid carcinoma (FTC) rarely metastasizes to regional lymph nodes, as they mainly metastasize through hematogenous route; in particular, a large FTC with only lateral lymph node metastasis and without distant metastasis has rarely been reported.
CASE REPORT
We present a 66-year-old male patient with a progressively growing thyroid for more than 20 years, causing tracheal compression and narrowing. Neck ultrasonography, computed tomography (CT), magnetic resonance (MR) imaging and positron emission tomography-computed tomography (PET/CT) were carried out to obtain images of the thyroid and surrounding tissues. Total thyroidectomy and cervical lateral and central lymph node dissection were undertaken, and histopathological, and immunohistochemical evaluations and molecular pathology confirmed the diagnosis of FTC with multiple cervical lymph node metastases.
CONCLUSION
We have reported a rare case of large FTC with diffuse nodal involvement but no distant metastases. We present the thyroid ultrasound, neck CT, MR and whole body PET/CT.
引言
滤泡性甲状腺癌（FTC）很少转移至区域淋巴结，因为它们主要通过血行途径转移；特别是，仅有侧方淋巴结转移且无远处转移的大滤泡性甲状腺癌鲜有报道。
病例报告
我们报告一名66岁男性患者，甲状腺渐进性增大20多年，导致气管受压和狭窄。进行了颈部超声、计算机断层扫描（CT）、磁共振（MR）成像和正电子发射断层扫描-计算机断层扫描（PET/CT）以获取甲状腺及周围组织的图像。实施了全甲状腺切除术及颈部侧方和中央淋巴结清扫术，组织病理学、免疫组织化学评估和分子病理学确诊为伴有多枚颈部淋巴结转移的FTC。
结论
我们报告了一例罕见的大滤泡性甲状腺癌，伴有弥漫性淋巴结受累但无远处转移。我们展示了甲状腺超声、颈部CT、MR和全身PET/CT。
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