超声引导下粗针穿刺诊断甲状腺T细胞淋巴瘤1例

Ultrasound-guided core-needle biopsy diagnosis of thyroid T-cell lymphoma:a case report

1病例报告患者,男,36岁,数年前诊断为桥本甲状腺炎,发现颈前明显肿大2个月。外院就诊查甲状腺彩超提示甲状腺肿大,回声不均匀,桥本甲状腺炎可能性大,右侧颈部多发淋巴结肿大。FT3、FT4、T3、T4正常,TSH 6.82μIU/mL,TGA 915.5IU/mL,TPO-Ab>1027IU/mL,CEA正常,细针穿刺提示桥本甲状腺炎可能性大。近两周来,患者出现吞咽梗阻感,为求进一步治疗,于2018年11月来我院就诊。体检:甲状腺右侧叶Ⅲ度肿大,左侧叶Ⅱ度肿大,质硬,无压痛,不能移动,无血管杂音。双侧颈部可触及多枚肿大淋巴结。

The rare entity of primary T-cell lymphoma of thyroid gland may pose great diagnostic challenges to the clinician. We report a case of malignant T-cell lymphoma of the thyroid gland that developed in a 36-year-old man with a past history of Hashimoto’s thyroiditis. The chief complaint was a rapidly growing neck mass and pressure symptoms. This man, diagnosed with Hashimoto’s thyroiditis for the previous several years. CT and ultrasonographic examination revealed a diffuse large thyroid gland with cervical lymphadenopathy. It was suspected that thyroid lymphoma involved regional lymph nodes. Fine needle aspiration cytology diagnosed chronic thyroiditis, and ultrasound-guided core needle biopsy was performed. Finally, peripheral T cell lymphoma was diagnosed.