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胸腺癌比较少见,位于颈上部者更少.我们曾遇1例,报道如下.患者,女,25岁.发现颈上前肿块10余年,近2年逐渐无痛性增大,无特殊不适.检查:颈前正中舌骨上缘有一4cm×4cm×2cm圆形肿块,边缘清楚,质中,表面光滑,可随吞咽上下活动,与周围皮肤无粘连.无压痛.门诊拟“甲舌囊肿”于1995年1月13日收治入院.B超检查:肿物里实质性;甲状腺无异常.T_3、T_4、TSH正常.同位素Ⅰ扫描:舌骨上肿物为冷结节,颈前正中甲状腺存在,腺内放射性分布均匀一致.纵隔CT扫描,未见胸腺肿瘤.1995年1月19日在颈丛麻醉下取舌骨水平横切口行肿物切除术.术中见肿物有很薄的包膜,暗红色,质软,表面光滑并有小血管附着,似甲状腺组织,不与舌骨粘连,将肿物完整切除.病理所见:肿物扁圆,3.0cm×2.8cm×1.5cm,表面呈结节状,有完整包膜,切面实性、色灰黄、质地细嫩.镜下见肿瘤由小淋巴细胞及上皮性细胞构成.小淋巴细胞占优势,弥漫分布,未见淋巴滤泡
Thymic cancer is rare, located in the upper part of the neck is less. We have encountered 1 case, the report is as follows. Patients, women, 25 years old. Found in the upper cervical mass for more than 10 years, nearly 2 years gradually painless increase, no special discomfort. Examination: There is a 4cm × 4cm × 2cm round mass on the upper edge of the mid hyoid bone in the middle of the neck. The edge is clear, the mass is medium, and the surface is smooth. It can move up and down with swallowing, and has no adhesion with the surrounding skin. No tenderness. The clinic intends to “A tongue cyst.” Admitted to hospital on January 13, 1995. B-ultrasound: substance in the mass; thyroid no abnormalities. T_3, T_4, TSH normal. Isotope I scan: hypochondral masses are cold nodules, the middle of the neck before the middle thyroid The distribution of radioactivity in the gland was uniform. There was no thymic tumor on the CT scan of the mediastinum. On January 19, 1995, horizontal hyoidectomy was performed under neck anaesthesia to perform mass resection. Membrane, dark red, soft, smooth surface and small blood vessels attached, like thyroid tissue, do not adhere to the hyoid bone, the tumor completely removed. Pathological findings: tumor oblate, 3.0cm × 2.8cm × 1.5cm, The surface is nodular, with complete envelope, cut surface solid, color gray yellow, fine texture. Microscopically, the tumor is composed of small lymphocytes and epithelial cells. Lymphocyte predominant, diffuse, no lymphoid follicles