【摘要】 目的总结甲状腺疾病并存局灶性淋巴细胞性甲状腺炎的诊治方法,并探讨其与桥本病混淆的原因。方法对近2 5年间经手术治疗病理诊断为桥本病的2 0 7例患者中,1 4 3例桥本病合并其他甲状腺疾病的临床资料进行回顾性分析。结果1 4 3例中5 7例为甲状腺疾病并存局灶性淋巴细胞性甲状腺炎,占桥本病的2 7.5%(5 7/2 0 7),占桥本病合并其它甲状腺疾病的3 9.9%(5 7/1 4 3)。术中病理切片显示局灶性淋巴细胞浸润的阳性率为8 7.7%(5 0/5 7)。术后甲状腺功能减退(甲减)的发生率为1 9.3%(1 1/5 7);其中亚临床型甲减7例,占1 2.3%(7/5 7)。结论甲状腺疾病并存局灶性淋巴细胞性甲状腺炎与甲状腺疾病并存桥本病两者病理改变的性质可能不同。术中切片检查有助于该病的诊断,并对指导手术切除腺体的范围具有重要的意义。更多还原

【Abstract】 Objective To evaluate the methods of diagnosis and treatment of thyroid disease with concomitant focal lymphocytic thyroiditis(FLT), and explore the reasons for its confused with Hashimoto′s disease(HD).Methods During the recent 25 years, 207 patients underwent surgical trearment for pathologically diagnosed HD.Among this group, 143 cases of HD with other concomitant thyroid disease were retrospectively analysed.Results Of the 143 cases, 57 cases were found to have thyroid disease with concomitant FLT, and this was 27.5%(57/207) of the total HD group, or 39.9%(57/143) of the group with thyroid disease and concomitant HD.Intraoperative pathologic section revealed that focal lymphocytic infiltration was positive in 87.7%(50/57) of cases. The postoperative hypothyroidism occurrence rate was 19.3%(11/57), of which, 7 cases(7/57, 12.3%) were subclinical hypothyroidism.Conclusions The character of pathologic changes of thyroid disease with FLT and with HD was different. Intraoperative pathologic section can be helpful in the diagnosis of this condition and can have important significance as a guide to the scope of (surgical) resection of the thyroid gland.更多还原