甲状腺结节鳞状上皮化生1例报道及文献复习  

Ultrasounographic finding of thyroid nodule with squamous metaplasia: report of a case and review of literature

作　　者：况李君 王怡[1] 陆采葑[2] 樊金芳 吴敏[2] 周伟[1,3] KUANG Lijun;WANG Yi;LU Caifeng;FAN Jinfang;WU Min;ZHOU Wei(Shanghai 200020,Ultrasonic Section,Luwan Branch of Ruijin Hospital,Affiliated Ruijin Hospital,Shanghai Jiao Tong University Medical College;Department of Pathology,Luwan Branch,Affiliated Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200020;Department of Ultrasound,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院超声科,上海200020 [2]上海交通大学医学院附属瑞金医院卢湾分院病理科,上海200020 [3]上海交通大学医学院附属瑞金医院超声科,上海200025

出　　处：《诊断学理论与实践》2019年第4期423-427,共5页Journal of Diagnostics Concepts & Practice

摘　　要：目的:探讨甲状腺结节鳞状上皮化生患者的常规超声及超声造影表现,以提高医师对该疾病的认识及诊断水平。方法:分析1例甲状腺结节鳞状上皮化生患者的常规超声特点及超声造影表现,并结合病理结果及相关文献进行讨论。结果:常规超声检查提示患者右侧甲状腺下极可见一低回声区,与包膜接触,形状欠规则,边缘尚清,内见细点状强回声;超声造影检查表现为不均匀增强,呈慢进、快退、低增强。最终患者经病理诊断为结节性甲状腺肿伴纤维结节鳞状上皮化生。结论:甲状腺结节伴鳞状上皮化生患者的超声表现缺乏特征性,易与甲状腺乳头状癌相混淆,明确诊断需依赖于术后标本的病理诊断。Objective: To investigate the ultrasounographic appearance of thyroid nodule with squamous metaplasia in conventional ultrasounography and contrast-enhanced ultrasounography(CEUS), so as to improve the understanding and diagnosis of the disease. Methods: The features on conventional ultrasounography and CEUS of thyroid nodule with squamous metaplasia in a patient were analyzed. The results in combination with pathological findings and relevant literatures were discussed. Results: The nodule was in the lower aspect of the right thyroid, contacting with the capsule. On conventional ultrasounographic examination, it appeared as an inhomogeneous hypoechoic, irregular and ill-defined nodule with microcalcification. CEUS showed slow wash-in and fast wash-out, obviously heterogeneous low enhancement. The final pathological result was nodular goiter with fibrous nodule forming squamous metaplasia. Conclusions: The ultrasounographic appearance of thyroid nodule with squamous metaplasia is not specific, and is similar to the features of papillary thyroid carcinoma. The final diagnosis depends on pathological examination of postoperative specimen.

关 键 词：甲状腺结节 鳞状上皮化生 超声 

分 类 号：R736.1[医药卫生—肿瘤]