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早期甲状腺癌由于缺乏特征性表现,易与其他甲状腺疾病相混淆,术前确诊较为困难。1986年7月至1999年7月共收治甲状腺癌96例,其中22例误诊为其他疾病,误诊率达22.9％,现分析如下。1 临床资料 本组男9例,女13例;年龄最小16岁,最大68岁。术前B超检查17例,其中囊性2例,实质性3例,混合型4例,非均质性8例。术前~(131)I同位素扫描8例,均为冷结节。术前诊断:甲状腺腺瘤17例,结节性甲状腺肿4例,颈部血管瘤1例。术中肿块穿刺细胞学检查7例,发现有癌细胞4例。术后病理类型:乳头状癌12例,滤泡状癌6例,髓样癌1例,未分化癌3例。2 讨论2.1 误诊原因分析2.1.1 甲状腺癌中的乳头状癌和滤泡状癌属低度恶性,由
Early thyroid cancer is often confused with other thyroid diseases because of its lack of characteristic performance. It is difficult to diagnose before the operation. From July 1986 to July 1999, 96 cases of thyroid cancer were treated, 22 of which were misdiagnosed as other diseases. The rate of misdiagnosis was 22.9%. The analysis is as follows. 1 clinical data in this group of 9 males and 13 females; youngest 16 years old, maximum 68 years old. Preoperative B-ultrasound examination in 17 cases, including 2 cases of cystic, 3 cases of substantial, mixed 4 cases, 8 cases of heterogeneity. Preoperative ~(131)I isotope scans were performed in 8 cases and all were cold nodules. Preoperative diagnosis: 17 cases of thyroid adenoma, 4 cases of nodular goiter and 1 case of cervical hemangioma. The intraoperative tumor mass was examined by cytological examination in 7 cases, and 4 cases of cancer cells were found. Postoperative pathological types included 12 cases of papillary carcinoma, 6 cases of follicular carcinoma, 1 case of medullary carcinoma, and 3 cases of undifferentiated carcinoma. 2 Discussion 2.1 Analysis of misdiagnosis 2.1.1 Papillary carcinoma and follicular carcinoma in thyroid cancer are of low grade.