甲状腺Hürthle细胞肿瘤:超声表现及诊断策略  

Hurthle Cell Neoplasm of the Thyroid:Sonographic Appearances and Diagnostic Strategy

作　　者：李鹏[1] 张惠[1] 陈路增[1] 柳萍[2] 

机构地区：[1]北京大学第一医院超声诊断科,北京市100034 [2]北京大学第一医院病理科,北京市100034

出　　处：《中国超声医学杂志》2014年第5期387-390,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨甲状腺H(u|¨)rthle细胞肿瘤的超声特征。方法回顾27个甲状腺H(u|¨)rthle细胞肿瘤的超声表现,并与病理结果对照。结果 27个甲状腺H(u|¨)rthle细胞肿瘤均为边界清晰、纵横比<1的椭圆形结节。29.6%为不伴囊性变的低回声结节,48.1%和22.1%为中等或中低混合回声结节,44.4%伴不同程度囊性变,3.7%有微小钙化,所有结节周边均有规整低回声晕。彩色多普勒血流显像88.8%周边血流环绕,内部血流丰富,11.1%仅内部少量血流。经超声引导下粗针穿刺活检,所有结节均能诊为甲状腺H(u|¨)rthle细胞肿瘤,但无法明确肿瘤良恶性。肿瘤完整切除后,2个结节由于H(u|¨)rthle细胞侵犯肿瘤包膜诊为H(u|¨)rthle细胞癌,其中1个内见小钙化,与超声结果相符。结论甲状腺H(u|¨)rthle细胞肿瘤的超声表现具有甲状腺良性结节的一般特点,其性质仅能通过完整肿瘤切除行病理学检查确定。Objective To investigate the role of ultrasonography in the diagnosis of Hürthle cell neoplasm （HCN） of the thyroid.Methods The sonographic features of 27 nodules of HCN were analyzed compared with the result of pathology.Results The shape and margin of the nodule were ovoid and smooth,anteroposterior to transverse dimension ratio ＜1 and halo sign present,in all cases.The echogenicity was hypoechoic,isoechoic,or mixed in 29.6％,48.1％ and 22.1％,respectively.Cystic change was present in 44.4％.Punctuate calcifications were present only in 3.7 ％.The vascularity was combined peri-and intranodular in 88.8 ％,and of the only intranodular in 11.1 ％.Ultrasound-guided core-needle biopsy of all nodules can be diagnosed as HCN,but not clearly benign or malignant.All HCNs were encapsulated on gross pathologic examination,two HCNs were diagnosed as malignancy because of visible Hürthle cell invasion of tumor capsule.Punctuate calcifications within a malignancy can be certified by pathology.Conclusions The sonographic appearances of HCN were similar to other benign tumor of the thyroid.Definite diagnosis depends on histopathological examination after total resection of the entire lesion.

关 键 词：甲状腺Hürthle细胞肿瘤 超声引导下粗针穿刺活检 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]