甲状腺扩散大B细胞淋巴瘤在一个患有哈希莫托甲状腺炎的患者:一个诊断困境
Shravya Singh Karki1, Shivam Pandey1, Smriti Karki2
1B. P. Koirala Institute of Health Sciences Dharan Nepal.
Clinical case reports
|October 27, 2025
概括
初级甲状腺淋巴瘤 (PTL) 是罕见的,并且经常被细针吸收细胞学 (FNAC) 误诊,特别是在哈希莫托甲状腺炎. 核心针活检 (CNB) 提高了PTL的诊断准确性,减少了延迟和不必要的手术.
科学领域:
- 在瘤学瘤学.
- 病理学 病理学 病理学
- 血液学 血液学 血液学
背景情况:
- 初级甲状腺淋巴瘤 (PTL) 是一种罕见的恶性瘤,占甲状腺癌的1-5%.
- 扩散性大B细胞淋巴瘤 (DLBCL) 是最常见的PTL亚型.
- PTL经常与哈西莫托甲状腺炎共存,使诊断复杂化.
研究的目的:
- 报告FNAC错误诊断的PTL病例.
- 突出FNAC在PTL中的诊断局限性.
- 强调先进的诊断技术的重要性,如CNB.
主要方法:
- 一个70岁的男性的病例报告,他的子有质量.
- 通过重复FNAC进行初始诊断,这是不确定的.
- 手术切除 (甲状腺切除) 随后进行了他的病理学和免疫组织化学.
主要成果:
- 组织病理学和免疫组织化学证实DLBCL,活性B细胞 (ABC) 亚型.
- FNAC对PTL的敏感性较低,特别是在同时发生甲状腺炎时.
- 核心针活检 (CNB) 提供了更高的诊断产量,并保留了组织结构.
结论:
- 在诊断PTL时,FNAC存在显著的局限性,特别是在甲状腺炎的存在时.
- 像免疫组织化学和CNB这样的先进技术对于准确的PTL诊断至关重要.
- 需要改进的诊断策略来早期检测PTL,特别是在资源有限的环境中.
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