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模仿或隐匿原发性甲状腺肿瘤的罕见甲状腺疾病:呼吁“检查再检查”的临床思维模式。

Rare Thyroid Diseases Mimicking or Concealing Primitive Thyroid Neoplasms: A Call for a "Check and Double-Check" Clinical Mindset.

作者信息

Duhamel Frederik, Balti Eric, Waelput Wim, Raeymaeckers Steven, Verfaillie Guy, Luyten Ine, Andreescu Corina E

机构信息

Endocrine and Diabetes Unit, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, BEL.

Department of Internal Medicine, Vrije Universiteit Brussel (VUB), Brussels, BEL.

出版信息

Cureus. 2024 Mar 23;16(3):e56777. doi: 10.7759/cureus.56777. eCollection 2024 Mar.

Abstract

Clinical endocrinologists encounter in their practice patients with thyroid diseases on a daily basis. Still, diagnosis of rare structural thyroid disorders can be quite challenging. In some instances, they do not only impersonate but can also conceal, other conditions such as thyroid carcinomas. We describe a series of patients with structural thyroid disorders including 1) anaplastic thyroid carcinoma initially presenting with features of thyroid abscess; 2) unicentric hyaline vascular Castleman's disease of the thyroid embedded in a stroma of papillary thyroid carcinoma; and 3) primary thyroid lymphoma with a rapid and fulminant evolution. The common challenge in the diagnosis of these cases lies in both their low incidence and their complex presentation. We use the presentation of these cases to raise the attention related to their identification. We highlight the need for precision diagnosis to enable a patient-tailored management approach and improve patient outcomes.

摘要

临床内分泌学家在日常工作中每天都会遇到患有甲状腺疾病的患者。然而,诊断罕见的甲状腺结构紊乱可能颇具挑战性。在某些情况下,它们不仅会模仿,还可能掩盖其他病症,如甲状腺癌。我们描述了一系列患有甲状腺结构紊乱的患者,包括:1)间变性甲状腺癌最初表现为甲状腺脓肿的特征;2)甲状腺单中心透明血管型Castleman病,包埋于甲状腺乳头状癌的间质中;3)原发性甲状腺淋巴瘤,病情迅速且呈暴发性发展。这些病例诊断中的共同挑战在于其发病率低且临床表现复杂。我们通过这些病例的呈现来提高对其识别的关注度。我们强调精准诊断的必要性,以便采取针对患者的管理方法并改善患者的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c456/11034573/540ac003e096/cureus-0016-00000056777-i01.jpg

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