Castleman病:放射性碘难治性甲状腺癌转移的巨大模仿者

N. Rashid, Aamna Hassan, N. Akhter, A. Hameed
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引用次数: 1

摘要

一名27岁男性因甲状腺肿大接受全甲状腺切除术。组织病理显示:甲状腺乳头状癌[T3 - 6.0 cm]伴甲状腺外扩张。患者接受150mci放射性碘(RAI)作为辅助消融治疗。放射性碘难治性疾病在rai治疗后1年确诊为甲状腺球蛋白水平升高和I-131全身扫描阴性。F-18 FDG正电子发射断层扫描/计算机断层扫描显示右侧甲状腺床和多节位右侧宫颈淋巴结活动。右侧改良颈部清扫,显示右侧颈淋巴结Castleman病(透明血管型)。随访超声检查发现肿瘤标志物升高的最可能原因为0.6 cm右甲状腺床结节。我们的病人也有共存的条件;骨质疏松症、丙型肝炎以及甲状腺癌。关键词:Castleman病,淋巴结,放射性碘,甲状腺癌
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CASTLEMAN DISEASE: A GREAT MIMICKER OF METASTASES IN RADIOIODINE REFRACTORY THYROID CANCER
A 27-year-old male underwent total thyroidectomy for thyroid swelling. Histopathology showed papillary thyroid carcinoma [T3 - 6.0 cm] with extra-thyroidal extension. The patient was treated with 150 mCi radioactive iodine(RAI) as adjuvant ablative therapy. Radioiodine refractory disease was identified 1-year post-RAI therapy with elevated thyroglobulin levels and negative I-131 whole body scan. F-18 FDG positron emission tomography/computedtomography scan showed activity in the right thyroid bed and multilevel right cervical nodes. Right-sided modified neck dissection was done, which showed Castleman disease (hyaline vascular type) in right cervical nodes. The most probable cause of elevated tumour markers was found out to be 0.6 cm right thyroid bed nodule on follow-up ultrasonography. Our patient also had coexistent conditions as; osteopoikilosis and Hepatitis C along with thyroid carcinoma.Key words: Castleman disease, lymph node, radioiodine, thyroid cancer
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