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目的探讨桥本甲状腺炎伴微小乳头状癌的临床病理学特点及诊断要点。方法对1例桥本甲状腺炎伴微小乳头状癌进行临床资料、病理形态学及免疫组化分析,并结合文献对其诊断及鉴别诊断进行探讨。结果患者女性,48岁,因体检发现颈部肿物行双侧甲状腺肿物切除术,术中冰冻检查结果示右叶甲状腺下极桥本甲状腺炎伴镜下微小乳头状癌,直径<2 mm。免疫组化结果示:CK19、Galectin-3、RET弥漫阳或灶阳;TPO阴性。结论桥本甲状腺炎伴微小乳头状癌易被忽视,提高对桥本甲状腺炎伴微小乳头状癌的认识,并在病理检查中认真仔细,对避免漏诊是至关重要的。
Objective To investigate the clinicopathological features and diagnosis points of Hashimoto’s thyroiditis with tiny papillary carcinoma. Methods One case of Hashimoto’s thyroiditis with papillary carcinoma was analyzed by clinical data, pathomorphology and immunohistochemistry, and its diagnosis and differential diagnosis were discussed. RESULTS: A 48-year-old female patient underwent bilateral thyroidectomy for neck mass examination. The intraoperative frozen-thaw results showed that the right inferior thyroid glandular hyperthyroidism with microscopic papillary carcinoma was smaller than 2 mm in diameter. Immunohistochemical results showed: CK19, Galectin-3, RET diffuse positive or Yang Yang; TPO negative. Conclusions Hashimoto’s thyroiditis with small papillary carcinoma is easily overlooked, raising the awareness of Hashimoto’s thyroiditis with tiny papillary carcinoma and being careful in pathological examination is crucial to avoid misdiagnosis.