甲状腺嗜酸细胞肿瘤28例诊治分析  

Hurthle cell thyroid tumor： an analysis of 28 cases

作　　者：杨晓勇[1] 胡传祥[1] 杨力珍[1] 赵文川[1] 潘毅[2] 

机构地区：[1]天津市肿瘤防治重点实验室天津医科大学附属肿瘤医院头颈外科,300060 [2]天津市肿瘤防治重点实验室天津医科大学附属肿瘤医院病理科,300060

出　　处：《中华耳鼻咽喉头颈外科杂志》2010年第11期908-911,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的 探讨甲状腺嗜酸细胞肿瘤的临床特点和治疗效果.方法 回顾性分析天津医科大学附属肿瘤医院头颈外科2001-2009年收治的28例甲状腺嗜酸细胞肿瘤患者临床资料.结果 患者中男6例,女22例;年龄18～72岁,中位年龄46.5岁.22例临床表现为甲状腺单发结节或肿块,6例表现为甲状腺多发结节.行单侧甲状腺腺叶切除11例,单侧甲状腺腺叶＋峡部切除11例,甲状腺近全切除术4例,2例行腺叶＋峡部切除及颈清扫术.术后病理：甲状腺嗜酸细胞腺瘤22例,嗜酸细胞癌6例,其中1例有颈淋巴转移.21例良性患者获得随访,随访时间6个月至7.5年,中位随访45个月,均未发现肿瘤复发;6例恶性患者均获得随访,随访时间3～8年,中位随访54个月,均未发现肿瘤复发或转移.结论 甲状腺嗜酸细胞肿瘤诊断依赖于病理学,部分病例有恶性可能,冰冻诊断有一定困难.手术是治疗嗜酸细胞肿瘤的有效手段.左旋甲状腺素片可起到抑制促甲状腺激素分泌的作用.Objective To explore the clinical features and the combined treatment modality of Hurthle cell thyroid tumor（HCT）. Methods Twenty-eight cases of HCT treated between 2001 and 2009were analyzed retrospectively. Results The age of the patients ranged from 18 to 72 years （with a median of 46.5 years）; 22 females and 6 males. The main symptoms were thyroid solitary node or mass（22 cases）and multiple nodule（6 cases）, 2 cases with cervical lymph node metastasis. All of the patients underwent surgery, 11 cases with thyroid lobectomy, 11 cases with thyroid lobectomy plus isthmusectomy, 4 cases with subtotal thyroidectomy, and 2 cases with thyroid lobectomy plus isthmusectomy and combined with modified radical cervical lymph node dissection. Postoperative pathological examination showed that 22 cases were Hurthle cell adenomas and 6 cases were Hurthle cell carcinomas, 1 of them with cervical lymph nodemetastasis. Twenty-one patients with Hurthle cell adenomas were followed up for 6 months to 7.5 years （with a median of 45 months） and 6 patients with Hurthle cell carcinomas for 3 to 8 years （with a median of 54 months）, with no recurrence and death case. Conclusions HCT is a potential malignant neoplasm.There are some difficulties in the diagnosis of HCT by frozen section. Surgery is an effective treatment for HCT. L-Thyroxine can be used to inhibit TSH excretion.

关 键 词：甲状腺肿瘤 腺瘤 嗜酸粒细胞 预后 

分 类 号：R686[医药卫生—骨科学]