吉林大学学报(医学版)

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甲状腺乳头状癌并发颈部淋巴结结核的超声影像学特征

吴文芳,邱金旭,卢丽敏,杨冬艳 
   

  1. 吉林大学中日联谊医院超声科,吉林 长春 130033
  • 收稿日期:2014-01-07 出版日期:2014-07-28 发布日期:2015-01-18
  • 通讯作者: 杨冬艳(Tel: 0431-84995140,E-mail: yangdongy@jlu.edu.cn) E-mail:yangdongy@jlu.edu.cn
  • 作者简介:吴文芳(1986-),女,湖北省荆州市人,在读医学硕士,主要从事腹部及浅表器官的超声诊断研究。
  • 基金资助:

    吉林省科技厅科技发展计划项目资助课题(20130206020SF)

Characteristics of ultrasound imaging of thyroid papillary carcinoma complicated with cervical lymph node tuberculosis

WU Wen-fang,QIU Jin-xu,LU Li-min,YANG Dong-yan   

  1. Department of Ultrasound,China-Japan Union Hospital,Jilin University,Changchun 130033,China
  • Received:2014-01-07 Online:2014-07-28 Published:2015-01-18

摘要:

目的:探讨甲状腺乳头状癌并发颈部淋巴结结核的超声影像学特征,阐明其超声诊断要点,并与甲状腺乳头状癌颈部淋巴结转移进行鉴别。方法:收集15例经临床手术病理证实的甲状腺乳头状癌并发颈部淋巴结结核患者的资料,其中6例同时并发淋巴结转移,分析肿大淋巴结超声表现,比较结核性淋巴结和转移性淋巴结的超声特征,包括发生的部位、钙化特征、液化情况及血流分布特征等。结果:甲状腺乳头状癌并发淋巴结结核多分布于颈部Ⅲ区、Ⅳ区及Ⅴ区,以Ⅴ区显著,淋巴结回声紊乱,结内钙化呈片状不均匀分布,液化部分透声极差,可见絮状弱回声,血流信号表现为周边或内部散在点状分布,淋巴结周围软组织回声增强、紊乱。结论:超声检查可疑甲状腺癌并发颈部淋巴结肿大患者时,应结合病史、分析其超声特征并观察淋巴结周围软组织病变后进行综合诊断。

关键词:  甲状腺肿瘤;颈部淋巴结转移;淋巴结结核;超声检查, 多普勒, 彩色

Abstract:

Objective To explore the ultrasound imaging characteristics of thyroid papillary carcinoma complicated cervical lymph node tuberculosis,and to elucidate
the key points of ultrasound diagnosis and to distinguish with cervical lymph node metastasis of papillary thyroid carcinoma.Methods In total,15 well-documented cases of papillarythyroid carcinoma diagnosed definitely were selected,and there were 6 cases of concomitant lymph node metastasis.The ultrasonography of lymph node enlargement was analyzed,and the differences of the ultrasonographic characteristics between lymph node tuberculosis and metastatic lymph node including the location,swelling,calcification,blood flow and regional nodal liquefaction.Results Thyroid papillary carcinoma complicated with cervical lymph node tuberculosis was often  found in the areas of Ⅲ,Ⅳ and Ⅴ,especially in the area of Ⅴ.Variety of echo was mixed in tuberculous of lymph node,and the echo was inhomogenous.The tuberculosis of lymph node calcification was patchy inhomogeneous distribution.The echo in part of liquefaction of lymph node tuberculosis was cottony weak.The flow signal of tuberculous lymph appeared the surrounding or internal punctate distribution,and the soft tissue was echogenic and disorder around the lymph node tuberculosis.Conclusion When ultrasonography examination is performed in the patients with the thyroid papillary carcinoma complicated with cervicallymph node enlargement, the history should be considered to analyze the ultrasound characteristics to dignose by observing the lesions of the surrounding soft tissues.
 

Key words: thyroid neoplasms, cervical lymph node metastasis, lymph node tuberculosis, ultrasonography,Doppler,color

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