甲状腺乳头状癌合并颈部局灶型Castleman病1例

Papillary thyroid carcinoma with cervical unicentric Castleman disease: a case report

目的探讨甲状腺乳头状癌(PTC)合并颈部局灶型Castleman病(UCD)的临床诊治经验。方法回顾性分析1例PTC合并颈部UCD的临床病例资料,并检索国内外文献。该患者术前行甲状腺结节穿刺细胞学检查(FNA)倾向PTC,合并右颈侧区淋巴结肿大,行甲状腺右侧腺叶合并峡部切除及右颈II、III、IV、VI区淋巴结清扫术。结果术后切口愈合良好,无声音嘶哑及低钙症状,术后4 d治愈出院。术后随访6个月无复发。术后病理证实颈侧区肿大淋巴结为UCD。结论 PTC合并UCD极为罕见,且UCD的术前诊断较为困难,但手术切除多可治愈;PTC合并颈部淋巴结肿大者,临床医生不仅需考虑甲状腺癌转移淋巴结可能,还需警惕UCD的存在。

Objective To investigate the clinical diagnosis and treatment of papillary thyroid carcinoma(PTC) with cervical Unicentric Castleman diease(UCD).Methods A retrospective analysis was performed on the clinical data of 1 case of PTC with cervical UCD. Then, we searched domestic and foreign literature, and summarized the main points of clinical diagnosis and treatment.The patient underwent preoperative thyroid nodule biopsy cytology(FNA) for PTC with lymph node enlargement in the right cervical region, which was underwent the right thyroid gland lobules and isthmic resection and dissection of lymph node II, III, IV and VI in the right cervical region.Results The patient was cured and discharged 4 days after the operation, his wound healed well without symptoms of hoarseness or hypocalcemia postoperative,and no recurrence by followed up for 6 months. Postoperative pathology confirmed that the enlarged lymph nodes in the lateral cervical region for UCDs.Conclusion PTC combined with UCD was extremely rare, and preoperative diagnosis of UCD was difficult.But surgical removal can often cure the disease. For patients with PTC combined with cervical enlarged lymph nodes, clinicians should not only consider the possibility of thyroid cancer metastatic lymph nodes, but also be alert to the presence of UCD.