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1989～1992年我院为177例甲状腺疾病患者施行手术。木后与术前诊断不一致者共17例(9. 6％)。其中误诊为亚急性甲状腺炎1例,慢性甲状腺炎9例,甲状腺癌7例(3.95％)。现将甲状腺癌的误诊原因分析如下。 一、临床资料 本组7例均为女性,年龄22～57岁,平均40.1岁。因颈前发现肿块10天～8年(平均16.6个月)就诊。体检:甲状腺触及单个给节者5例,两侧均触到结节及结节性甲状腺肿各1例。颈部均未触及肿大淋巴结。~(131)碘扫描5例,冷结节2例,凉结节、热结节及结节性甲状腺肿各1例。B型超声检查2例,均为实质性肿块。拍颈部X线片1例,未见钙化影。术前诊断为结节性甲状腺肿2例,甲状腺腺癌5例,分别行腺叶次全切除术和腺叶切除术。
From 1989 to 1992, 177 patients with thyroid disease underwent surgery in our hospital. A total of 17 cases (9.6%) were found to be inconsistent with preoperative diagnosis. One case was misdiagnosed as subacute thyroiditis, 9 cases were chronic thyroiditis, and 7 cases were thyroid cancer (3.95%). The reasons for the misdiagnosis of thyroid cancer are analyzed as follows. First, the clinical data in this group of 7 cases were female, aged 22 to 57 years, mean 40.1 years old. The patient had a mass of 10 to 8 years (average 16.6 months) because of a finding in front of the neck. Physical examination: The thyroid gland touched a single donor in 5 cases, and both had nodules and nodular goiters on either side. Neck did not touch the enlarged lymph nodes. ~ (131) iodine scan in 5 cases, cold nodules in 2 cases, cold nodules, hot nodules and nodular goiters in 1 case. B-ultrasonography was performed in 2 cases and all were solid lumps. X-ray film was taken in 1 case and no calcification was seen. Preoperative diagnosis was 2 cases of nodular goiter and 5 cases of thyroid adenocarcinoma. Subtotal glandectomy and lobectomy were performed.