甲状腺乳头状癌肺转移与细支气管肺泡癌的鉴别诊断

甲状腺乳头状癌肺转移与细支气管肺泡癌有着各自不同的生物学特性及临床特点，治疗方法也不尽相同。通过临床、病理及影像检查大多能将两者鉴别。但临床上有些病例如甲状腺、肺、颈部淋巴结甚至腋窝淋巴结均发现病灶，临床及影像检查难以确定是甲状腺乳头状癌肺转移还是细支气管肺泡癌，抑或是双原发，加之甲状腺乳头状癌与细支气管肺泡癌在病理学上有些相似之处，如沙粒体的出现、TTF-1表达阳性等，给鉴别诊断增加了一定的困难。两者的鉴别应结合临床、病理、影像学等多方面考虑，综合分析，以求诊断明确，为下一步治疗提供可靠的依据。

The Differential Diagnosis of Thyroid Papillary Carcinoma Pulmonary Metastasis and Bronchioalveolar Carcinoma

Thyroid papillary carcinoma pulmonary metastasis and bronchioalveolar carcinoma have similar biological and clinical characteristics. The treatment for each of these two conditions is different. They can be discriminated by clinical features, pathology and imaging. For patients who have nodules in the thyroid, lung, axillary nodes and lymph nodes of the neck, it is hard to determine whether the condition is thyroid papillary carcinoma pulmonary metastasis or bronchioalveolar carcinoma. We discuss a case to emphasize the importance of using a combination of clinical features, pathology and imaging in the differential diagnosis of the two conditions.