肉芽肿性甲状腺炎误诊为甲状腺癌临床分析  

Clinical Analysis of Granulomatous Thyroiditis Misdiagnosed as Thyroid Carcinoma

作　　者：章双艳 王梦丹 王建华[1] ZHANG Shuang-yan;WANG Meng-dan;WANG Jian-hua(Department of Thyroid and Breast Surgery,the Affiliated Hospital of Integrated Traditional Chinese and Western Medicine of Nanjing University of Traditional Chinese Medicine,Nanjing 210023,China)

机构地区：[1]南京中医药大学附属中西医结合医院甲乳外科,南京210023

出　　处：《临床误诊误治》2022年第8期13-15,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的 分析肉芽肿性甲状腺炎误诊为甲状腺癌的原因及二者的临床病理特征差异。方法 回顾性分析2018—2020年8例肉芽肿性甲状腺炎误诊为甲状腺癌的临床资料。结果 8例均因体检发现甲状腺结节就诊,术前均未诉明显不适表现,并于术前行彩超、穿刺细胞学、甲状腺功能、CT等检查,考虑甲状腺癌可能性大。经评估患者符合手术指征,均行手术治疗,术后病理学检查提示肉芽肿性甲状腺炎。8例术后规律口服左甲状腺素片补充甲状腺激素,定期门诊随访。结论 肉芽肿性甲状腺炎发病率较低,因其影像学特征与甲状腺癌相似,较易误诊和漏诊。故超声及临床医生应仔细辨别,对不能明确诊断者可考虑临床观察或再次行彩超和穿刺细胞学检查,以减少误诊误治。Objective To analyze the causes of misdiagnosis of granulomatous thyroiditis as thyroid cancer and their difference in clinicopathological features.Methods Clinical data of 8 cases of granulomatous thyroiditis misdiagnosed as thyroid cancer from 2018 to 2020 were retrospectively analyzed.Results All the 8 patients presented with thyroid nodules found in physical examination,without complaining of obvious discomfort before surgery.They underwent color Doppler ultrasonography,puncture cytology,thyroid hormone,CT and other examinations before surgery.and the possibility of thyroid cancer was considered.After evaluation,all the patients met the surgical indications and underwent surgical treatment.Postoperative pathological examination confirmed granulomatous thyroiditis.All 8 patients regularly taken levothyroxine tablets to supplement thyroid hormone after operation,and were followed up regularly.Conclusion The incidence of granulomatous thyroiditis is low,and its imaging features are similar to those of thyroid cancer,which,therefore,possibly leads to misdiagnosis and missed diagnosis.Therefore,Radiologists and clinicians should distinguish carefully,and clinical observation or color ultrasound and puncture cytology can be considered again for those who cannot be clearly diagnosed,so as to reduce misdiagnosis and mistreatment.

关 键 词：肉芽肿性甲状腺炎 误诊 甲状腺肿瘤 超声检查 穿刺活检 

分 类 号：R581.4[医药卫生—内分泌]