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细针穿刺后急性短暂性甲状腺肿大:病例系列及系统评价

Acute transient thyroid swelling following fine-needle aspiration: a case series and a systematic review.

作者信息

Zhang Da-Kun, Zhu Xin-Yan, Guan Jing-Bo, Li Zhi-Xuan, Li Yun-Lin, Gao Jie

机构信息

Department of Ultrasound, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

出版信息

Gland Surg. 2025 May 30;14(5):888-896. doi: 10.21037/gs-2025-66. Epub 2025 May 27.

Abstract

BACKGROUND

Acute transient thyroid swelling (ATTS) is a rare complication of fine-needle aspiration (FNA) of thyroid nodules. Most cases were in spontaneous remission. However, it is fatal in rare cases. However, there are few literature reports, so it is of great significance to improve the clinical understanding of ATTS. Therefore, this study aimed to present 10 institutional cases and a systematic review of 18 literature cases to delineate clinical features, imaging findings, and management approaches.

METHODS

Twenty-eight clinical cases (10 cases from institutional archives and 18 cases from literature search) were included in the retrospective analysis. Data collection continued until August 1, 2024.

RESULTS

ATTS following FNA is a rare complication. Among the 28 total cases (10 institutional, 18 literature), 89% were female. Bilateral goiter occurred in 71%. Symptoms typically emerged within one hour following FNA, resolving spontaneously within 24 hours in 79% of cases. Neck pain/swelling (54%) was common; severe complications (dyspnea, cardiac arrest) were rare (3%). Ultrasound revealed unilateral/bilateral goiter with linear/patchy hypoechoic areas and preserved vascularity. Non-pharmacological management sufficed for most patients.

CONCLUSIONS

ATTS following FNA is self-limiting, with distinct ultrasound findings. Clinicians should prioritize airway management in severe cases and avoid unnecessary interventions in mild presentations.

摘要

背景

急性短暂性甲状腺肿大(ATTS)是甲状腺结节细针穿刺活检(FNA)的一种罕见并发症。大多数病例可自发缓解。然而,在极少数情况下是致命的。然而,相关文献报道较少,因此提高对ATTS的临床认识具有重要意义。因此,本研究旨在呈现10例机构病例以及对18例文献病例的系统回顾,以描述其临床特征、影像学表现和管理方法。

方法

纳入28例临床病例(10例来自机构档案,18例来自文献检索)进行回顾性分析。数据收集持续至2024年8月1日。

结果

FNA后发生的ATTS是一种罕见并发症。在28例病例(10例机构病例,18例文献病例)中,89%为女性。71%出现双侧甲状腺肿大。症状通常在FNA后1小时内出现,79%的病例在24小时内自发缓解。颈部疼痛/肿胀(54%)很常见;严重并发症(呼吸困难、心脏骤停)很少见(3%)。超声显示单侧/双侧甲状腺肿大,伴有线性/片状低回声区且血管分布正常。大多数患者非药物治疗即可。

结论

FNA后发生的ATTS具有自限性,超声表现独特。临床医生在严重病例中应优先进行气道管理,在轻症病例中避免不必要的干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb0e/12177542/67d47cb0f218/gs-14-05-888-f1.jpg

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