当科における甲状腺細胞診の検討  [in Japanese] Fine Needle Aspiration Cytology under Ultrasonographic Imaging for Diagnosis of Thyroid Tumor  [in Japanese]

Access this Article

Search this Article

Author(s)

    • 吉川 琢磨 YOSHIKAWA Takuma
    • 国家公務員共済組合連合会立川病院耳鼻咽喉科 Department of Otorhinolaryngology, Tachikawa Hospital, Kokka-koumuin Kyousaikumiai Rengoukai
    • 吉田 晋也 YOSHIDA Shinya
    • 国家公務員共済組合連合会立川病院耳鼻咽喉科 Department of Otorhinolaryngology, Tachikawa Hospital, Kokka-koumuin Kyousaikumiai Rengoukai
    • 浅川 剛志 ASAKAWA Takeshi
    • 国家公務員共済組合連合会立川病院耳鼻咽喉科 Department of Otorhinolaryngology, Tachikawa Hospital, Kokka-koumuin Kyousaikumiai Rengoukai

Abstract

当科において,甲状腺摘出術を施行した55例について,超音波ガイド下FNAと術後病理診断の一致率とシンチグラフィー検査の診断精度について検討したところ,諸家の報告とほぼ同様であった。<br>Tcシンチでcold, Tlシンチでdelay陽性と悪性を示唆するパターンが見られても,FNAの結果がclass 1,2であれば腺腫様甲状腺腫のことが多く,class 3でも超音波,CT検査での高輝度石灰化,壁の不整などの所見がなければ,病理組織学的に良性のことが多く,手術をせずに経過観察でよいものと考えられた。腺腫様甲状腺腫症例を検討しても同様の結果であった。<br>濾胞腺腫と濾胞癌の鑑別は細胞診や超音波では難しいが,今回の検討では,細胞診とシンチグラフィーと画像診断を加えた総合診で診断できた。

We compared the ultrasound (US)-guided, fine-needle aspiration biopsy (FNAB) diagnosis, surgical pathology and isotope findings in 55 cases of thyroid surgery. Our diagnostic accuracy was the same as in other reports. Scintigraphical pattern suggesting malignancy is cold spot for Tc and hot spot for <sup>201</sup>Tl in delay image. When FNAB was class 1 or 2, this pattern appeared almost as an adenomatous goiter. If there were no findings of calcification and irregular wall in the ultrasound or the CT examination, class 3 cases were judged benign. Many cases were considered acceptable for a wait-and-see strategy without operation. Ultrasound and CT differential diagnosis was difficult for follicular adenoma and follicular carcinoma. However, we could make a totality diagnosis by cytology, scintigraphy, ultrasound and CT in our study. Adenomatous goiter was seen usually as hot scintigraphy of the <sup>201</sup>Tl delay image. If there were no findings of calcification or irregular wall in the ultrasound or CT examination, cases with hot scintigraphy of the <sup>201</sup>Tl delay image were almost always adenomatous goiter. This pattern was also considered acceptable for a wait-and-see strategy without operation.

Journal

  • Nihon Kikan Shokudoka Gakkai Kaiho

    Nihon Kikan Shokudoka Gakkai Kaiho 53(1), 27-32, 2002-02-10

    The Japan Broncho-esophagological Society

References:  9

Cited by:  1

  • Enucleation of Cystic Thyroid Tumor  [in Japanese]

    KOJIMA Tsuyoshi , SHOJI Kazuhiko , IKEGAMI Satoshi , SUZUKI Shinji , KISHIMOTO Yo , TAKAHASHI Atsuhito

    Practica oto-rhino-laryngologica 99(1), 49-54, 2006-01-01

    Ichushi Web  References (11)

Codes

  • NII Article ID (NAID)
    10008385258
  • NII NACSIS-CAT ID (NCID)
    AN00187474
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    00290645
  • Data Source
    CJP  CJPref  J-STAGE 
Page Top