甲状腺髓样癌(medullary carcinoma of the thyroid,MTC)是来源于甲状腺滤泡旁细胞的少见恶性神经内分泌肿瘤,发病率低但恶性度高。高频超声可表现为甲状腺恶性结节或良性结节的超声特征,因其超声表现缺乏特征性导致鉴别诊断困难。弹性成像显示多数MTC结节的硬度值偏低,较难与良性结节鉴别。MTC患者颈部淋巴结转移较常见,其超声表现与甲状腺乳头状癌淋巴结转移表现类似。虽然细针抽吸活组织检查(fine needle aspiration biopsy,FNAB)诊断MTC阳性率较低,但目前仍不失为较简单且准确有效的诊断方法。对穿刺物冲洗液行降钙素检测,同时结合血清降钙素及原癌基因RET的检查有助于MTC的准确诊断。
Abstract
Medullary carcinoma of the thyroid (MTC) originates from parafollicular cells of thyroid
it is a rare malignant neuroendocrine tumor with low incidence but high malignancy. High-frequency ultrasound shows the characteristics of both malignant thyroid nodules and benign nodules. The lack of specific ultrasound findings makes differential diagnosis difficult. Elastography shows that the hardness of most MTC nodules is low
making it difficult to distinguish benign nodules. MTC patients with cervical lymph node metastasis are common
and their ultrasound findings are similar to those of lymph node metastasis in papillary thyroid carcinoma. Although fine needle aspiration biopsy has a low positive rate in the diagnosis of MTC
it is still the simpler
most accurate and eff
ective diagnostic method at present. The detection of calcitonin in the flushing fluid of the puncture combined with the examination of serum calcitonin and proto-oncogene
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Related Author
Hong HAN
Qing LU
Yuli ZHU
Peili FAN
Huixiong XU
ZHANG Ying
ZHANG Yifeng
XU Huixiong
Related Institution
Department of Ultrasound, Zhongshan Hospital of Fudan University
Institute of Ultrasound in Medicine and Engineering of Fudan University
Shanghai Institute of Medical Imaging
Department of Medical Ultrasound, Shanghai Tenth Peoples Hospital, Tongji University
Medical School, Kunming University of Science and Technology