自身免疫性甲状腺疾病活检病理分析

Bioptic Pathology in the Diagnosis of Autoimmune Thyroid Disease

分析自身免疫性及非自身免疫性甲状腺疾病共52例患者的病理改变，并与临床诊断和实验室检查进行比较。结果显示活极成功率为93．0％，病理诊断率91．2％，活检前临床诊断与病理符合率68．4％。较多临床诊断为Graves病的患者实为甲亢伴甲状腺炎或桥本甲亢。电镜检查对自身免疫性甲状腺疾病的鉴别诊断有较大价值。部分桥本甲状腺炎或桥本甲亢患者自身抗体TgAb和TMAb测定呈阴性结果。

Fifty-seven patients with different kinds of thyroid diseases received coarse needle biopsy(CNB).Histopathologic diagnosis was contrasted with accuracy of clinical diagnosis and laboratory evaluation. The value of ultrasturctrual pathology in differentiating autoimmune thyroid diseases (AITD) was also studied in some cases. Of 57 CNB cases, 52 (91. 2% ) samples were adequate for histologic diagnosis. The accuracy of clinical prebioptic diagnosis was only 68. 4% in contrast to histopathology. Some patients with thyrotoxic symptoms were histologically Hashitoxicosis (HSHT) or thyrotoxicosis with thyroiditis (TTOT). In some patients with histologically diagnosed Hashimoto's thyroiditis (HT), the circulating autoantibodies TgAb and TMAb were negative. The ultrastructural pathology was quite helpful in evaluating AlTD.