结节性甲状腺肿并存其他甲状腺疾病(附84例报告)

NODULAR GOITER COEXISTED WITH OTHER THYROID DISEASES (With 84 Cases Reported)

目的：总结结节性甲状腺肿并存其他甲状腺疾病临床特点、误诊原因及治疗要点。方法：回顾并结合文献分析近年收治且经病理证实结节性甲状腺肿并存其他疾病８４例临床资料。结果：结节性甲状腺肿并存甲状腺癌２０例，并存良性甲状腺肿瘤５３例，并存桥本氏甲状腺炎１１例。结论：结节性甲状腺肿可能是甲状腺癌一种癌前病变，甲状腺肿内的变性肿瘤可能是腺肿形成甲状腺癌的桥梁。应放宽结节性甲状腺肿的手术指征，一旦发现。

OBJECTIVE: To summarize clinical features, causes of misdiagnosis and treatment of nodular goiter coexisted with other thyroid diseases. METHODS: Clinical data of 84 cases with nodular goiter coexisted with other thyroid diseases was analysed. RESULTS: 20 cases of nodular goiter coexisted with thyroid carcinoma; 1 coexisted with Hashimoto’s thyroiditis; 53 coexisted with benign thyroid tumors. CONCLUSIONS: Nodular goiter may be one of the precancerous changes of thyroid carcinoma. The degenerative tumor inside goiter will possibly develop into thyroid carcinoma. Broad operational indications and active surgical intervention are suggested.