Ferrozzi F, Campodonico F, De Chiara F, Uccelli M, Saccani A
Istituto di Scienze Radiologiche, Università degli Studi di Parma.
Radiol Med. 1997 Sep;94(3):214-9.
The modern integrated approach to neoplastic diseases permits to detect metastatic lesions in uncommon sites, such as the thyroid gland. We reviewed the ultrasonographic (US) and Computed Tomographic (CT) patterns of secondary thyroid lesions, comparing imaging findings with primary tumor histopathologic diagnosis.
We reviewed a series of 10 thyroid metastases diagnosed from 1986 to 1995 at staging (4 cases) or follow-up (6 cases) examinations; in the latter, metastases were diagnosed 39 to 89 months (mean: 58 months) after the primary tumor. The patients were 7 women and 3 men, 55 to 94 years old (mean: 65 years). The final diagnosis was made at cytology (4 cases), histology (5 cases) or surgery (1 case).
The primary tumors were breast cancer (2 cases), melanoma (2 cases), small cell lung cancer, bronchioalveolar carcinoma, mucoid stomach adenocarcinoma, renal carcinoma, colon carcinoma and leiomyosarcoma (1 case each). The thyroid lesion was unifocal in 6 patients and multifocal in 2; the gland was diffusely involved in 2 patients. Dysphagia was found in all patients. Thyroid function was normal in 6/7 patients and one had hyperthyroidism; normofunctional goiter was found in another patients. US showed focal or diffusely infiltrating hypoechoic lesions; likewise, inhomogeneously hypodense areas with mild contrast enhancement were observed at CT. Thyroid secondary lesions exhibited variable patterns when necrotic, hemorrhagic or calcific areas were included; correlations with primary tumor-pathogenetic and histologic features were often observed. Survival rate was 2-60 months (mean: 19 months).
Since imaging findings in thyroid metastases are often not specific and sometimes atypical, fine needle biopsy of suspicious lesions should be carried out for both staging and follow-up.
现代肿瘤疾病综合诊疗方法能够检测出甲状腺等不常见部位的转移病灶。我们回顾了继发性甲状腺病变的超声（US）和计算机断层扫描（CT）表现，并将影像学检查结果与原发肿瘤组织病理学诊断结果进行了比较。
我们回顾了1986年至1995年期间在分期检查（4例）或随访检查（6例）中诊断出的一系列10例甲状腺转移瘤；在后一组中，转移瘤在原发肿瘤后39至89个月（平均58个月）被诊断出来。患者包括7名女性和3名男性，年龄在55至94岁之间（平均65岁）。最终诊断通过细胞学检查（4例）、组织学检查（5例）或手术（1例）确定。
原发肿瘤为乳腺癌（2例）、黑色素瘤（2例）、小细胞肺癌、细支气管肺泡癌、黏液性胃腺癌、肾癌、结肠癌和平滑肌肉瘤（各1例）。甲状腺病变在6例患者中为单灶性，2例为多灶性；2例患者甲状腺呈弥漫性受累。所有患者均有吞咽困难。7例患者中有6例甲状腺功能正常，1例患有甲状腺功能亢进；另1例患者发现为功能正常的甲状腺肿。超声显示为局灶性或弥漫性浸润性低回声病变；同样，CT检查发现不均匀低密度区域伴有轻度对比增强。当包含坏死、出血或钙化区域时，甲状腺继发性病变表现出多种形态；常观察到与原发肿瘤致病和组织学特征的相关性。生存率为2至60个月（平均19个月）。
由于甲状腺转移瘤的影像学表现通常不具有特异性，有时甚至不典型，因此对于可疑病变应进行细针穿刺活检，以用于分期和随访。
