갑상선 유두암과 결핵성 경부 림프절염이 동반된 환자들에서 경부 림프절의 평가

정은욱; 장영수; 이정복; 최성용; 이낙준; 소윤경; 정한신

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자료유형: 학술저널

저자정보: 정은욱 장영수 이정복 최성용 이낙준 소윤경 정한신

저널정보: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후과학회지 두경부외과학 제55권 제9호

발행연도: 2012.1

수록면: 571 - 577 (7page)

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Background and Objectives To determine the diagnostic clues to differentiate tuberculous lymph node infection from nodal metastasis in patients with both papillary thyroid carcinoma and cervical tuberculous lymphadenitis. Subjects and Method We retrospectively reviewed 11 patients suffering concurrently from papillary thyroid carcinomas with cervical tuberculous lymphadenitis. Nine of the 11 patients underwent preoperative neck ultrasonography (US) and seven CT scans. Using the surgical pathology as the reference standards, the results of the preoperative diagnostic tools were re-evaluated according to lymph node level-based analysis. US and CT features were also compared between metastatic nodes and tuberculous lymphadenitis. Results Preoperative CT could localize the involved lymph node levels and differentiate tuberculous infection from metastasis of thyroid carcinoma in only two of seven patients. The site of the involved lymph nodes, the presence of pulmonary tuberculosis, and the tumor volume of the thyroid carcinoma were the clues to diagnose the lymph node status. However, in five of seven cases, CT could not differentiate tuberculosis from metastasis in the lymph nodes. The morphological characteristics of lymph nodes seen on CT and US did not differ between tuberculous infection and metastasis of papillary thyroid carcinomas. Conclusion Pre-operative CT or US does not provide differential information about lymph node status between tuberculous infection and metastasis in patients with concurrent papillary thyroid carcinomas and cervical tuberculous lymphadenitis. Rather, clinical characteristics such as the site of the involved lymph nodes, the primary tumor burden, and the associated clinical features can help the physician differentiate between them.

#Lymph nodes #Lymphatic metastasis #Thyroid carcinoma #Tuberculous lymphadenitis

참고문헌 (23)

참고문헌 신청

Ahuja A / 1998 / Solitary cystic nodal metastasis from occult papillary carcinoma of the thyroid mimicking a branchial cyst: a potential pitfall / Clin Radiol 53 (1) : 61 ~ 6

Ahuja A / 2002 / An overview of neck node sonography / Invest Radiol 37 (6) : 333 ~ 342

Ahuja AT / 1995 / Metastatic cervical nodes in papillary carcinoma of the thyroid: ultrasound and histological correlation / Clin Radiol 50 (4) : 229 ~ 231

Ahuja AT / 2005 / Sonographic evaluation of cervical lymph nodes / AJR Am J Roentgenol 184 (5) : 1691 ~ 1699

Aljafari AS / 2004 / Diagnosis of tuberculous lymphadenitis by FNAC, microbiological methods and PCR: a comparative study / Cytopathology 15 (1) : 44 ~ 48