粗针穿刺诊断桥本甲状腺炎进展为甲状腺淋巴瘤并文献复习

Thyroid lymphoma progressed with Hashimoto′s thyroiditis diagnosed by core-needle biopsy : case report and literature review

目的探讨粗针穿刺活检(core-needle biopsy, CNB)对于甲状腺淋巴瘤诊断的意义。方法1例病史数十年桥本甲状腺炎的病例,患者表现为颈部增粗数月,细针穿刺活检(fine-needle aspiration, FNA)并未发现异常,对其进行CNB及流式细胞学检查。结果CNB及流式细胞学检查最终确诊为甲状腺淋巴瘤。结论慢性桥本甲状腺炎患者短期出现颈部增粗等症状,高度怀疑甲状腺淋巴瘤但是FNA阴性时,可采用CNB活检,结合流式细胞术和免疫组织化学检查,以便早期诊断。

Objective To explore the significance of core-needle biopsy (CNB) in the diagnosis of thyroid lymphoma. Methods A case of Hashimoto′s thyroiditis for several decades, showed a thickening of the neck for several months, and no abnormalities were found by the method of fine-needle aspiration(FNA), then we performed CNB and flow cytology analysis. Results Thyroid lymphoma was finally diagnosed through CNB and flow cytology. Conclusion Thyroid lymphoma should be considered when the neck became thickened in short time in patients with chronic Hashimoto′s thyroiditis. Core-needle biopsy accompanied with flow cytometry and immunohistochemistry analysis should be suggested as routine diagnostic method especilly when fine-needle aspiration was negative.