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患者男,68岁。颈前肿物20余年,近增长加速伴右头疼,影响呼吸、睡眠。查气管偏向左后,颈静脉不怒张。颈前3个结节状肿物,左、峡部及右侧各1个。均有表面光滑、质硬的特点,右侧者最大,为15×15cm,峡部及左侧肿物随吞嚥活动。在锁骨上可扪及玉米粒大淋巴结。X线检查,见右侧块状阴影的上缘模糊,密度不均,可见多数棉团及砂粒样钙化堆集。左侧阴影唯边缘不光滑与之不同。按结节性腺瘤行手术治疗。病理检查切除的囊性腺叶,见甲状腺包膜边缘散在多量被有内皮细胞的血窦,海绵状,排列混乱,腔大小不等,内充满红细胞。诊断:甲状腺海绵状血管瘤。
Male patient, 68 years old. The neck mass was more than 20 years old. Accelerated growth was associated with right head pain, affecting breathing and sleeping. After checking that the trachea is biased to the left, the jugular vein is not engorged. Three nodular masses in front of the neck, one on the left, one on the isthmus, and one on the right. All of them have the characteristics of smooth surface and hard texture. The largest one on the right side is 15 × 15cm. The isthmus and the left mass are swallowed. In the clavicle can be licked and corn large lymph nodes. X-ray examination shows that the upper edge of the block shadow on the right is fuzzy and the density is uneven. Most cotton groups and sand-like calcifications can be seen. The shadow on the left side is not the same as the edge. Nodular adenoma surgery. Pathological examination of the resection of the cystic gland leaves, see the edge of the thyroid envelope scattered in a large number of endothelial sinusoids, spongy, arranged in disorder, the size of the cavity, filled with red blood cells. Diagnosis: Thyroid cavernous hemangioma.