结节性甲状腺肿伴桥本病临床病理分析及文献复习

目的 探讨结节性甲状腺肿及结节性甲状腺肿伴桥本病的病理特征及意义。方法 回顾分析结节性甲状腺肿病例中伴有桥本病的5例病例的临床病理特征。结果 全部病例均经病理检验，418例结节性甲状腺肿中有5例伴有桥本病。2例结节性甲状腺肿伴桥本病者术前做甲状腺球蛋白抗体（TGA）检测：1例阳性，1例阴性。上述5例病例中3例为术中冰冻切片诊断，另外2例为回顾性诊断时发现。甲状腺滤泡上皮嗜酸性变是桥本病的重要病理特征，术中冰冻切片更容易找到嗜酸性变的甲状腺滤泡上皮。结论 结节性甲状腺肿伴桥本病的发病率是很高的，病理人体检验时仔细取材是减少桥本病漏诊的关键，术中冰冻切片有利于快速而准确地诊断结节性甲状腺肿伴桥本病。

Clinical pathological analysis and review of literature of Nodular goiter accompanied by Hashimoto disease

Objective To explore the pathological features and meaning of the nodular goiter accompanied by Hashimoto disease. Methods The clinical pathological features of 418 cases of nodular goiter were reviewed including nodular goiter accompanied by Hashimoto disease. Resuits All cases were surgically treated and diagnosed by pathology. It was found in total 418 cases that 5 cases of nodular goiter accompanied by Hashimoto disease, in which the blood TAG was examinated in 2 cases before operations and one case was positive , the another was negative. 2 cases of nodular goiter accompanied by Hashimoto disease were found in review of nodular goiter accompanied by lymphocytic invagination. 3 cases were diagnosed in frozen stice during thyrodectomy were performed. The red fatty thyroid follicle epithelial cells were the important feature of Hashimoto disease, which was easily observed in frozen stice. Conclusions The incidence of nodular goiter accompanied by Hashimoto disease is higher. The key to find this series of desease is examining the specimen more carefully during the gross research . It is helpful to lead to diagnosis when a frozen stice is made during thyrodectomy.