Tumino S, Fornito C, Laudani A, Iurato M P, Belfiore A
Istituto di Medicina Interna e Specialità Internistiche, Cattedra di Endocrinologia, Ospedale Garibaldi, University of Catania, Italy.
Thyroid. 1997 Dec;7(6):897-900. doi: 10.1089/thy.1997.7.897.
We report three cases of autonomously functioning thyroid nodules (AFTNs) that appeared hypofunctioning at radioactive iodine (131I) thyroid scan carried out at initial observation. Since at that time thyroid hormones and thyrotropin (TSH) were also normal, they were initially classified as "cold" nodules and treated with levothyroxine (LT4). The correct diagnosis of AFTN was made years later when a thyroid scintigraphy was repeated. In two of these patients, re-evaluation of the nodule was done because of the development of LT4 intolerance. A possible explanation is that these AFTNs had undergone hemorrhagic/cystic degeneration when they were first studied, but in subsequent years, proliferation of residual AFTN tissue caused the recurrence of a typical functioning nodule.
我们报告了3例自主功能性甲状腺结节（AFTN）病例，这些结节在初次观察时进行放射性碘（131I）甲状腺扫描时表现为功能减退。由于当时甲状腺激素和促甲状腺激素（TSH）也正常，它们最初被归类为“冷”结节，并接受左甲状腺素（LT4）治疗。数年后重复进行甲状腺闪烁显像时才做出AFTN的正确诊断。在其中2例患者中，由于出现LT4不耐受而对结节进行了重新评估。一种可能的解释是，这些AFTN在首次检查时发生了出血/囊性变性，但在随后的几年中，残余AFTN组织的增殖导致典型功能性结节复发。
