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桥本甲状腺炎的鉴别诊断：病理解剖学的重要性。

Differential diagnosis of Hashimoto's thyroiditis: The importance of pathological anatomy.

作者信息

Vargas-Uricoechea Hernando, Meza-Cabrera Ivonne, Castellanos-Pinedo Alejandro, Urrego-Noguera Karen, Pinzón-Fernández María V

机构信息

Department of Internal Medicine, Faculty of Health Sciences, University of Cauca, Popayán, 190001 Cauca, Colombia.

Department of Pathology, Faculty of Health Sciences, University of Cauca, Popayán, 190001 Cauca, Colombia.

出版信息

J Biol Methods. 2025 Aug 7;12(3):e99010064. doi: 10.14440/jbm.2024.0139. eCollection 2025.

DOI:10.14440/jbm.2024.0139
PMID:40937371
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12422120/
Abstract

BACKGROUND

Hashimoto's thyroiditis (HT) represents a complex, multifactorial autoimmune disease characterized by a broad spectrum of clinical and imaging presentations. These manifestations tend to be clinically perplexing, necessitating additional tests. In cases where a malignancy is suspected or obstructive symptoms are present, surgical management may be required. Histopathologically, HT is hallmarked by significant lymphocytic infiltration of the thyroid gland, typically with prominent germinal centers, small lymphocytes, centrocytes, centroblasts, plasma cells, and occasionally immunoblasts. The degree of fibrosis varies, giving the gland a lobulated appearance and, in some cases, resulting in a fibrous variant, which, biochemically, is usually accompanied by hypothyroidism.

OBJECTIVE

This review provided a diagnostic and differential approach to HT, highlighting the utility of histopathological examination.

CONCLUSION

Histopathological analysis helps broaden the diagnostic and therapeutic horizon in individuals with HT.

摘要

背景

桥本甲状腺炎（HT）是一种复杂的多因素自身免疫性疾病，具有广泛的临床和影像学表现。这些表现往往在临床上令人困惑，需要进行额外的检查。在怀疑有恶性肿瘤或出现梗阻症状的情况下，可能需要手术治疗。组织病理学上，HT的特征是甲状腺有显著的淋巴细胞浸润，通常有明显的生发中心、小淋巴细胞、中心细胞、中心母细胞、浆细胞，偶尔还有免疫母细胞。纤维化程度各不相同，使腺体呈现分叶状外观，在某些情况下会导致纤维变体，在生化方面，通常伴有甲状腺功能减退。

目的

本综述提供了一种HT的诊断和鉴别方法，强调了组织病理学检查的实用性。

结论

组织病理学分析有助于拓宽HT患者的诊断和治疗视野。

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