Pencea V, Dobrescu G, Gneazdovschi V, Rusu M, Cernea M
Endocrinologie. 1977 Oct-Dec;15(4):271-4.
Coexistence of an autonomous thyroid adenoma (ATA) with chronic thyroiditis suggests a complex pathogeny pointing to the autonomous character of the nodule and to the presence of immunitary disorders. The rarity of this association and the paucity of data prompted us to present 4 cases of a series of 71 thyroidectomized ATA cases. The rarity of ATA associated with chronic thyroiditis, accumulation of radioiodine under the conditions of euthyroidism only at the adenoma level as well as the possibility for the disease to occur in hypopituitarism, all support the hypothesis of an initial thyreotropic deficiency, with subsequent hyperplasia "of necessity". Later on there is an autonomous hyperfunction increasing pituitary depression, with total extinction of the thyroid tissue outside the adenoma. When the two lesions are associated, we consider that initially there was the TSH-dependent thyroiditis that developed during which, by accidental depression of TSH secretion a local hyperplasia occurs which later becomes autonomous.
自主性甲状腺腺瘤（ATA）与慢性甲状腺炎并存提示其发病机制复杂，既与结节的自主性特征有关，也与免疫紊乱的存在有关。这种关联的罕见性以及数据的匮乏促使我们在71例接受甲状腺切除术的ATA病例系列中呈现4例。ATA与慢性甲状腺炎相关的罕见性、仅在腺瘤水平甲状腺功能正常情况下放射性碘的蓄积以及该病在垂体功能减退时发生的可能性，均支持最初存在促甲状腺素缺乏，随后“必然”出现增生的假说。随后出现自主性功能亢进，加重垂体抑制，导致腺瘤外甲状腺组织完全消失。当这两种病变并存时，我们认为最初存在促甲状腺素依赖性甲状腺炎，在此期间，由于促甲状腺素分泌意外降低，出现局部增生，随后变为自主性增生。
