Smith S A, Gharib H, Goellner J R
Arch Intern Med. 1987 Feb;147(2):311-2. doi: 10.1001/archinte.147.2.311.
The usefulness of fine-needle aspiration (FNA) for the diagnosis and management of metastatic carcinoma to the thyroid was determined by reviewing the records of 19 patients identified during a six-year period. Fine-needle aspiration was able to document metastatic cancer to the thyroid in 14 patients with, and five patients without a history of prior nonthyroidal cancer. Breast, kidney, and lung were the most frequent carcinomas metastatic to the thyroid. Age range and time from diagnosis of the primary carcinoma to documentation of metastasis were similar to those in prior surgical series from this institution. The finding of metastatic disease on FNA was totally unexpected in four patients. The possibility of metastasis was not mentioned before FNA in six patients with a known history of nonthyroidal cancer. Only six patients underwent a thyroid operation after FNA. Fine-needle aspiration was able to direct appropriate surgical or conservative management without adversely affecting survival among patients.
通过回顾六年期间确诊的19例患者的病历，确定了细针穿刺抽吸术（FNA）在甲状腺转移性癌诊断和管理中的实用性。细针穿刺抽吸术能够在14例有既往非甲状腺癌病史和5例无既往非甲状腺癌病史的患者中确诊甲状腺转移性癌。乳腺、肾脏和肺是最常见转移至甲状腺的癌。年龄范围以及从原发性癌诊断到转移确诊的时间与该机构之前的手术系列报道相似。在4例患者中，FNA发现转移性疾病完全出乎意料。在6例已知有非甲状腺癌病史的患者中，FNA之前未提及转移的可能性。FNA后仅6例患者接受了甲状腺手术。细针穿刺抽吸术能够指导适当的手术或保守治疗，且不会对患者的生存率产生不利影响。
