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46例甲状腺Hurthle细胞肿瘤的诊断与治疗
Diagnosis and treatment of thyroid Hurthle cell neoplasms
【摘要】 目的总结甲状腺Hurthle细胞肿瘤(HCNs)的诊断与治疗经验。方法回顾性分析1972年-2003年手术治疗甲状腺HCNs的临床资料。结果37例临床表现为甲状腺单发结节或肿块,9例表现为甲状腺多发结节。4例HCNs有颈淋巴结转移。初诊虽经BUS、CT、ECT及FNAC检查,仅10例诊断HCNs。术前细针穿刺活检及术中快速冷冻病理切片确诊HCNs 28例,良性者行同侧甲状腺全切除,恶性者加作对侧甲状腺切除术。术后石蜡病理切片确诊18例,首次手术时漏诊HCNS而行二次手术者切除原则同首次手术。46例手术后均治愈。经2-10年随访,无复发转移。结论应充分认识甲状腺HCNs,术中若疑似HCNs,应行快速冷冻病理切片检查,如能正确选择合适的手术方法,预后佳良。
【Abstract】 Objective To summarize our experience in the diagnosis and treatment of thyroid Hurthle cell neoplasms. Methods Clinical data of thyroid Hurthle cell neoplasm patients admitted from 1972 to 2003 were analyzed retrospectively. Results The main symptoms were thyroid solitary node or mass (37 cases) and multiple nodule (9 cases). 4 cases had cervical lymph node metastasis. With BUS、CT、ECT and FNAC,only 10 cases were diagnosed as HCNs preoperatively, 36 cases were misdiagnosed as nodular benign single or multiple node. Twenty-eight cases were diagnosed by FNAC and quick freezing pathology. Benign HCNs was treated by isolateral thyroidectomy and malignant HCNs by additional contralateral subtotal thyroidectomy. Eighteen cases were diagnosed by postoperative paraffin pathology, and retrival second operation was performed according to the benignity or malignancy of the thyroid lesion. All cases were followed-up for 2 to 10 years and doing well without recurrence. Conclusions We should realize thyroid Hurthle cell neoplasms fully, if HCNs is suspected intraoperatively, quick freezing pathology is helpful. With appropriate therapy, the prognosis is satisfactory.
【Key words】 Thyroid neoplasms; Adenoma, oxyphilic; Diagnosis; Surgical procedures, operative;
- 【文献出处】 中华普通外科杂志 ,Chinese Journal of General Surgery , 编辑部邮箱 ,2006年07期
- 【分类号】R736.1
- 【被引频次】3
- 【下载频次】129