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中华诊断学电子杂志 ›› 2022, Vol. 10 ›› Issue (01) : 59 -62. doi: 10.3877/cma.j.issn.2095-655X.2022.01.012

病例诊断思维

甲状腺孤立性纤维性肿瘤的超声诊断学特征并文献复习
王安琪1, 张磊2,†(), 王全义3, 王少春2   
  1. 1. 272013　济宁医学院临床医学院
    2. 272029　济宁医学院附属医院超声科
    3. 272029　济宁医学院附属医院病理科
  • 收稿日期:2020-11-23 出版日期:2022-02-26
  • 通信作者: 张磊
  • 基金资助:
    济宁医学院国家自然科学基金培育项目(JYP201736)

Ultrasonic diagnostic features of solitary fibrous tumors of thyroid and literature review

Anqi Wang1, Lei Zhang2,†(), Quanyi Wang3, Shaochun Wang2   

  1. 1. Clinical Medical College, Jining Medical University, Jining 272013, China
    2. Department of Ultrasound, The Affiliated Hospital of Jining Medical University, Jining 272029, China
    3. Department of Pathology, The Affiliated Hospital of Jining Medical University, Jining 272029, China
  • Received:2020-11-23 Published:2022-02-26
  • Corresponding author: Lei Zhang
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引用本文：

王安琪, 张磊, 王全义, 王少春. 甲状腺孤立性纤维性肿瘤的超声诊断学特征并文献复习[J/OL]. 中华诊断学电子杂志, 2022, 10(01): 59-62.

Anqi Wang, Lei Zhang, Quanyi Wang, Shaochun Wang. Ultrasonic diagnostic features of solitary fibrous tumors of thyroid and literature review[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2022, 10(01): 59-62.

目的

探讨甲状腺孤立性纤维性肿瘤的超声诊断学特征。

方法

回顾性分析2020年7月29日就诊于济宁医学院附属医院甲状腺外科的1例甲状腺孤立性纤维性肿瘤患者的临床资料和影像学、病理学检查结果，并复习相关文献。

结果

患者颈前偏左局限性隆起，甲状腺左叶可触及一明显肿物。超声可见甲状腺左叶一不均质回声团块，大小约5.8 cm×4.0 cm×2.7 cm，界清，形态规则，后方回声衰减，内可及较丰富的分支状血流信号。甲状腺CT平扫及增强扫描可见甲状腺左叶内略低密度影，增强后呈不均匀性延迟强化，呈"快进慢出"的特点。术后病理诊断为孤立性纤维性肿瘤。

结论

超声对甲状腺孤立性纤维性肿瘤的大小、形态、内部回声、血流情况具有一定特征性，结合其他检查可提高该病的临床诊断率。

关键词: 甲状腺, 孤立性纤维性肿瘤, 梭形细胞肿瘤, 超声检查
Objective

To investigate the ultrasonic diagnostic features of solitary fibrous tumor of thyroid.

Methods

The clinical data, imaging and pathological findings of a patient with solitary fibrous tumor of thyroid who was admitted to the Thyroid Surgery Department, the Affiliated Hospital of Jining Medical University on July 29, 2020 were retrospectively analyzed, and relevant literatures were reviewed.

Results

The patient had a localized bulge on the left front of the neck, and an obvious mass was palpable in the left lobe of the thyroid. Ultrasound showed an inhomogeneous echo and well-defined mass in the left lobe of the thyroid, about 5.8 cm×4.0 cm×2.7 cm with regular shape, attenuation of posterior echo, and abundant braching blood flow signals. Plain CT scans showed a slightly low-density shadow in the left lobe of the thyroid, and it showed uneven delayed enhancement, which was characterized by " fast in and slow out" . The pathological diagnosis of subtotal thyroidectomy was solitary fibrous tumor.

Conclusion

Ultrasound has certain specific features in size, shape, internal echo and blood flow of solitary fibrous tumor of thyroid, which can improve the clinical diagnosis rate of the disease combined with other examinations.

Key words: Thyroid gland, Solitary fibrous tumor, Spindle cell tumor, Ultrasonography
图1 甲状腺孤立性纤维性肿瘤患者甲状腺超声图像注：a图为甲状腺二维超声图，示甲状腺左叶实性不均质回声团块，界清，内回声不均；b图为彩色多普勒超声图，示团块后方回声衰减，其内较丰富血流信号(Adler分级Ⅱ级)(箭头所示)
图2 甲状腺孤立性纤维性肿瘤患者甲状腺增强CT图像注：甲状腺左叶内略低密度影，密度不均，呈不均匀强化，内见小片状无强化区(箭头所示)
图3 甲状腺孤立性纤维性肿瘤患者甲状腺肿块切除术后病理图像注：细胞丰富，偶见核分裂象(HE ×100)(箭头所示)
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