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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。
Objective To summarize the diagnosis and treatment experience of thyroid Hurthle cell tumors (HCNs). Methods The clinical data of surgical treatment of thyroid HCNs from 1972 to 2003 were retrospectively analyzed. Results 37 cases showed a single nodular or thyroid thyroid gland, and 9 cases showed multiple thyroid nodules. Four cases of HCNs had cervical lymph node metastases. Although only BUS, CT, ECT, and FNAC examinations were performed in the initial diagnosis, only 10 cases diagnosed HCNs. Preoperative microneedle aspiration biopsy and intraoperative rapid frozen pathological biopsy confirmed 28 cases of HCNs, benign patients underwent ipsilateral total thyroidectomy, and malignant patients were treated with contralateral thyroidectomy. Postoperative paraffin pathology was diagnosed in 18 cases. The first operation was missed with HCNS and the second operation was performed with the same principle as the first operation. 46 cases were cured after surgery. After 2-10 years of follow-up, there was no recurrence. Conclusions Thyroid HCNs should be fully understood. If HCNs are suspected during surgery, rapid-frozen pathological biopsy should be performed. If proper surgical procedures are properly selected, the prognosis is good.