甲状腺转移瘤超声表现

The ultrasonographic characteristics of metastatic carcinoma of the thyroid gland

目的探讨甲状腺转移瘤的超声影像特征。方法对11例甲状腺转移瘤病人[男8例,女3例;年龄49~73岁,平均年龄(62.3±6.3)岁]的临床、病理及超声表现进行回顾性分析,观察超声影像特征,并进行超声分型。结果 11例甲状腺转移瘤病人中6例单侧甲状腺受累,5例双侧甲状腺均受累。11例病例中5例呈单结节型(来源于肺2例,食管、肾脏、直肠各1例),最大径3.0~5.6 cm(平均3.9 cm);4例呈多结节型(来源于食管、肾脏、直肠、舌各1例),最大径1.5~3.8 cm(平均2.5 cm);2例呈弥漫性病变型(来源于肺、乳腺各1例)。实性结节或肿块病灶超声表现为低回声,形态不规则,边界不清,无晕环,内回声不均,无囊变、钙化,丰富血流信号,伴颈部淋巴结肿大。弥漫性病变超声均表现为双侧甲状腺弥漫性体积增大,回声减低不均,内探及丰富血流信号,伴颈部淋巴结肿大。结论甲状腺转移瘤具有一定的超声影像特征,结合病史有助于甲状腺转移瘤的诊断。

Objective To investigate the sonographic features of metastatic carcinoma of the thyroid gland. Methods The ultrasonographic and histopathological data of 11 cases with metastatic carcinoma of thyroid gland were analyzed retrospectively. The ultrasonic types of metastatic carcinoma of the thyroid gland were classified according to the appearances of ultrasonography. In the 11 cases, there were 8 males and 3 females with a mean age of 62.3 ±6.3 years, aged from 49~73 years old. Results In 11 the cases, six patients had unilateral thyroid involvement and 5 had bilateral thyroid involvement. Five cases showed single nodule type （from lung in 2 cases, and from esophagus, kidney, and rectum 1 for each）. The range of the largest diameter of lesions was from 3.0 to 5.6 cm （mean 3.9 cm）. 4 cases showed multiple nodules type （from esophagus, kidney, rectum, and tongue 1 for each）. The range of the largest diameter of lesions was from 1.5 to 3.8 cm （mean 2.5 cm）. Two cases showed diffuse type （from lung and breast 1 for each）. The single nodule and multiple nodules type presented as hypoechoic lesion with heterogeneous echo, irregular, ill defined contour, abundant flood and cervical lymph node enlargement, without halo, cystic degeneration and calcification. The diffuse type presented as hypoechoic lesion with diffused enlargement of the gland, heterogeneous echo, and abundant flood. All of them had cervical lymph node enlargement. Result The metastatic carcinoma of the thyroid gland has certain characteristics on ultrasonography. The ultrasonography is valuable in the diagnosis of the metastatic carcinoma of the thyroid gland when combining patient’s clinical history.