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错误的阳性成像对于由骨内血管瘤引起的乳头甲状腺癌
Heejoo Kang1, Frederick Thurston Drake1, David McAneny1
1Department of Surgery, Section of Endocrine Surgery, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA 02118, USA.
JCEM case reports
|November 1, 2023
概括
骨内血管瘤 (IH) 可以模仿皮质甲状腺癌患者的骨转移,导致错误的阳性核成像. 手术切除可能是必要的,以区分IH和恶性瘤,避免不必要的治疗.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 核医学就是核医学.
背景情况:
- 乳头甲状腺癌 (PTC) 的管理包括监测甲状腺蛋白水平和对转移进行成像.
- 骨内血瘤 (IH) 是一种良性血管瘤,可以发生在骨中,并以溶性病变的形式出现.
- 区分转移性PTC与良性骨病变可能是传统成像的挑战.
研究的目的:
- 突出在PTC患者和提升的甲状腺球蛋白中的虚假阳性成像发现的潜力.
- 为了说明计算机断层扫描 (CT),磁共振成像 (MRI) 和核成像在区分转移性PTC和IH的诊断局限性.
- 强调在甲状腺癌患者的光骨病变的差异诊断中考虑IH的重要性.
主要方法:
- 两名患有乳头甲状腺癌和甲状腺蛋白水平升高的患者的病例报告.
- 图像研究的审查,包括CT,MRI和I-123放射性扫描.
- 通过手术切除,通过组织病理学证实骨内血栓瘤 (IH).
主要成果:
- 两位患者都出现了可疑转移的形骨病变.
- 图像学研究 (CT,MRI,核扫描) 表明转移性疾病,但最终证实为IH.
- 假阳性结果突出了使用当前成像方法区分转移性PTC和IH的局限性.
结论:
- 骨内血管瘤可以在转移性分化甲状腺癌的成像检查中呈现为假阳性.
- 核成像,CT和MRI在患有性骨病变的患者中,在明确区分转移性PTC和IH方面存在局限性.
- 骨病变的切割可能是有必要的,以确立诊断,并防止并发症,如大脑入侵或不必要的放射性治疗.
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