Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
Department of Pathology, Gifu University, Gifu, Japan.
Neuroradiology. 2024 Oct;66(10):1795-1803. doi: 10.1007/s00234-024-03442-8. Epub 2024 Aug 13.
The present study aimed to investigate CT imaging features, pathological findings, and prognosis in patients with thyroid hemiatrophy (THA) associated with papillary thyroid carcinoma (PTC).
This retrospective study included 225 patients with histopathologically proven PTC treated by surgical resection who underwent preoperative CT scanning. On CT images, THA was defined as thyroid parenchymal hemiatrophy on the ipsilateral side of PTC. CT findings, overall survival, and disease-free survival were compared between patients with and without THA. Pathological findings were also assessed in PTCs with and without THA.
THA was observed in 35 of 225 (16%) patients with PTC. Atrophic thyroid parenchyma was observed in the right lobe of 20 patients (57%) and in the left lobe of the remaining 15 patients (43%). With respect to the solid components within PTCs, contrast-enhanced CT attenuation (114.2 ± 18.2 vs. 126.7 ± 31.3 HU; p < 0.05) and CT attenuation change for contrast-enhanced CT minus unenhanced CT (60.2 ± 18.1 vs. 72.3 ± 31.0 HU; p < 0.05) were significantly lower in PTCs with THA than in those without THA. Histopathologically, almost all PTCs with THA (97%) had keloid-like collagen, which is broad bundles of hypocellular collagen with bright eosinophilic hyalinization, typically observed in keloid. However, no significant differences were observed in the prognosis between the two groups.
THA was occasionally observed in patients with PTC. Weak contrast-enhancement was distinct characteristic of PTC patients with THA, which is probably caused by keloid-like collagen.
本研究旨在探讨与甲状腺乳头状癌（PTC）相关的甲状腺半侧萎缩（THA）患者的 CT 影像学特征、病理表现和预后。
本回顾性研究纳入了 225 例经手术切除且术前接受 CT 扫描的病理证实为 PTC 的患者。在 CT 图像上，THA 定义为 PTC 对侧甲状腺实质半侧萎缩。比较了有和无 THA 的患者的 CT 表现、总生存率和无病生存率。还评估了有和无 THA 的 PTC 中的病理表现。
在 225 例 PTC 患者中有 35 例（16%）存在 THA。20 例患者（57%）右侧甲状腺萎缩，其余 15 例患者（43%）左侧甲状腺萎缩。在 PTC 内的实性成分方面，THA 患者的增强 CT 衰减值（114.2±18.2 比 126.7±31.3 HU；p<0.05）和增强 CT 减未增强 CT 的衰减值变化（60.2±18.1 比 72.3±31.0 HU；p<0.05）明显低于无 THA 的患者。组织病理学上，几乎所有有 THA 的 PTC（97%）都有类瘢痕胶原，这是一种宽束状的细胞稀疏胶原，伴有明亮的嗜酸性玻璃样变性，通常见于瘢痕疙瘩。然而，两组患者的预后无显著差异。
在 PTC 患者中偶尔会观察到 THA。THA 患者的 PTC 增强程度较弱是其明显的特征，这可能是由类瘢痕胶原引起的。
