老年甲状腺良性结节可疑超声特征与病理对照分析

发布时间：2018-03-27 22:39

本文选题：甲状腺结节　切入点：超声　出处：《中国老年学杂志》2016年12期

【摘要】：目的从病理学角度探讨具有可疑超声特征的老年甲状腺良性结节术前误诊原因。方法选取老年甲状腺良性结节患者355例,其中术前超声误诊为甲状腺癌22例(29个结节),收集术前超声声像图,术中取甲状腺结节组织,术后复查病理切片,分析超声误诊病例的超声和病理表现。结果甲状腺结节最大径≤10 mm组内部结构为实性、极低回声、纵横比1的比例明显高于最大径10 mm组,钙化率明显低于最大径10 mm组(P0.05);29个术前超声误诊甲状腺结节术后病理诊断:结节性甲状腺肿19例(27个结节),非典型腺瘤2例(2个结节),亚急性甲状腺炎1例(无具体结节);可疑征象的甲状腺良性结节中主要病理表现为广泛纤维化伴玻璃样变、钙化,出现比例明显高于浓缩胶质、骨化生等另外6种病理表现(P0.01)。结论老年结节性甲状腺结节在退行性变中可能出现可疑超声征象,其病理基础为结节内广泛纤维化、钙化。
[Abstract]:From the view of pathology objective to explore the causes of misdiagnosis of senile benign thyroid nodules in patients with suspicious sonographic features. Methods 355 cases of elderly patients with benign thyroid nodules, 22 cases of thyroid cancer among preoperative misdiagnosis (29 nodules), preoperative ultrasonography, and thyroid nodule tissue during surgery, postoperative pathology analysis of ultrasound and pathology biopsy, ultrasound misdiagnosed cases of thyroid nodules. The maximum diameter of less than 10 mm group internal structure is solid, the extremely low echo, the aspect ratio of 1 was significantly higher than the proportion of the maximum diameter of 10 mm group, calcification rate was significantly lower than the maximum diameter of 10 mm group (P0.05); 29 preoperative ultrasound misdiagnosis thyroid nodules in the postoperative pathological diagnosis: 19 cases of nodular goiter (27 nodules), 2 cases of atypical adenoma (2 nodules), 1 cases of subacute thyroiditis (no specific nodules); the main pathological thyroid benign nodules showed signs of suspicious Extensive fibrosis and hyalinization, calcification, appeared significantly higher than the proportion of concentrated colloid, osseous metaplasia further 6 pathology (P0.01). Conclusion the elderly nodular thyroid nodules may appear suspicious sonographic signs of degeneration, the pathological basis for extensive fibrosis nodules, calcification.

【作者单位】：郑州市骨科医院;
【基金】：河南省医学科技攻关计划项目(No.2014ZC01014)
【分类号】：R445.1;R581

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