プランマー病の病勢が優位と考えられたマリン－レンハルト症候群の1例
| Jazyk: | angličtina |
|---|---|
| Rok vydání: | 2019 |
| Předmět: | |
| Zdroj: | 産業医科大学雑誌 = Journal of UOEH. 41(2):165-170 |
| Popis: | A 74-year-old woman with a left neck mass and thyrotoxicosis was referred to our hospital, and was later diagnosed with Marine-Lenhart syndrome based on positivity for thyroid autoantibodies, ultrasonographically evident left lobe thyroid nodule with increased blood flow, and scintigraphically identified not only increased tumorlike accumulation but also diffused uptake. Disease control was difficult despite administration of antithyroid drugs, so subtotal thyroidectomy was performed. No hyperplastic changes or histopathological findings characteristic of Graves disease were evident on histopathology, so Plummer disease was considered to be dominant. In case of hot in low type which showed higher uptake in the nodule and lower uptake in the extranodular part on scintigraphy, there is a possibility of relapse in drug treatment. 症例は74歳，女性，左頸部腫瘤および甲状腺中毒症を認め，当院を受診，甲状腺自己抗体陽性，頸部エコーにて血流亢進像を伴う甲状腺左葉の結節を認め，シンチグラフィで腫瘤状の集積亢進像と周囲のびまん性の弱い集積を認め，マリン－レンハルト症候群と診断した．抗甲状腺薬で加療されたがコントロール困難となり，甲状腺亜全摘術を施行した．病理組織像は，過形成変化やバセドウ病に特徴的な組織所見を認めなかった．以上からプランマー病の病勢が優位であったと考えられた．シンチグラフィで腫瘤に強い集積と周囲にびまん性の弱い集積を認めるHot in low型の症例では，内服治療では再燃する可能性がある． |
| Databáze: | OpenAIRE |
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