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目的探讨原发性甲状腺淋巴瘤(PTL)的临床诊疗经验。方法回顾性分析笔者所在医院收治的1例原发性甲状腺淋巴瘤病例的临床资料和诊疗经过,并进行相关文献复习。结果患者颈部肿物进行性增大且伴有压迫症状,术前行粗针穿刺活检(CNB)及免疫组化检查提示不除外肿瘤性病变,未能明确诊断,遂采取手术治疗,术后确诊为弥漫性大B细胞淋巴瘤,进一步行化学治疗。结合文献复习,PTL好发于中老年女性,因其常伴有慢性甲状腺炎,故容易被混淆。对于中老年人、短期内甲状腺明显增大、超声提示弥漫性或局限性低回声病变,应高度警惕PTL可能。对于诊断困难、局部有压迫症状的患者,可行手术治疗明确诊断及解除局部症状,对于诊断明确的病例,放化疗是主要的治疗手段。结论 PTL是一种较为少见的甲状腺恶性肿瘤,临床诊断较困难,不断总结病例,结合多种诊断学方法,注意慢性甲状腺炎与PTL的鉴别诊断,对早期诊断、早期治疗、提高患者生活质量有很大帮助。
Objective To investigate the clinical experience of treatment of primary thyroid lymphoma (PTL). Methods A retrospective analysis of the author’s hospital admitted to a case of primary thyroid lymphoma in clinical data and diagnosis and treatment after the relevant literature review. Results The neck mass of the patients progressed progressively and accompanied with oppression symptoms. The CNB and immunohistochemical examinations showed no tumor lesions except preoperative diagnosis. Surgical treatment was performed after surgery Confirmed as diffuse large B cell lymphoma, further line of chemotherapy. Combined with literature review, PTL occurs in middle-aged and older women, because it is often accompanied by chronic thyroiditis, it is easy to be confused. For the elderly, the short term thyroid was significantly increased, ultrasound prompted diffuse or localized hypoechoic lesions, PTL should be highly vigilant. For the diagnosis of difficult, local patients with symptoms of oppression, feasible surgical treatment of a clear diagnosis and the lifting of local symptoms, for the diagnosis of clear cases, radiotherapy and chemotherapy is the main treatment. Conclusions PTL is a rare thyroid malignant tumor. It is difficult to diagnose thyroid malignant tumor. Continuously summarizing the cases, combined with various diagnostic methods, pay attention to the differential diagnosis of chronic thyroiditis and PTL. To early diagnosis and early treatment, improve the quality of life of patients Great help.