CAJ | 학술논문

甲状腺结节是最常见的内分泌代谢疾病,多为意外结节.良恶性的鉴别是甲状腺结节诊治的关键,除详细采集病史及查体外,高分辨率超声、促甲状腺激素水平测定及细针穿刺活检是甲状腺结节诊断的基础.内分泌医生应掌握甲状腺穿刺活检的适应证,当病理报告无法分辨良恶性时,应选择分子或基因诊断进一步明确,根据不同的结果选择合适的治疗方案.本文列举1例典型的甲状腺结节最终被诊断为甲状腺乳头状癌并进行手术治疗的过程,力求使临床医生进一步重视及规范诊治甲状腺结节.
갑상선결절시최상견적내분비대사질병,다위의외결절.량악성적감별시갑상선결절진치적관건,제상세채집병사급사체외,고분변솔초성、촉갑상선격소수평측정급세침천자활검시갑상선결절진단적기출.내분비의생응장악갑상선천자활검적괄응증,당병리보고무법분변량악성시,응선택분자혹기인진단진일보명학,근거불동적결과선택합괄적치료방안.본문열거1례전형적갑상선결절최종피진단위갑상선유두상암병진행수술치료적과정,력구사림상의생진일보중시급규범진치갑상선결절.
[Summary] Thyroid nodules are the most common endocrine and metabolic diseases,and most of them are accidental nodules.How to distinguish the state between benign and malignant thyroid nodules is the clinical core problems in diagnosis and treatment.In addition to detailed history collecting and physical examination,highresolution ultrasound,serum thyrotrophin levels,and fine needle aspiration biopsy (FNAB) form the basis for the diagnosis of thyroid nodules.Endocrinologists should grasp the indications of FNAB.When the pathological finding is unable to distinguish between benign and malignant nodules,molecular or genetic diagnosis should be adopted for further diagnosis.Appropriate treatment is selected according to the definitive results.In this article,we share the whole process that one case with thyroid nodule was diagnosed as papillary thyroid carcinoma and eventually treated with surgery,so as to make clinicians pay more attention to thyroid nodules with standardized clinical diagnosis and treatment.