甲状腺髓样癌的CT表现及病理基础

目的：探讨甲状腺髓样癌（MTC）的CT表现特点和病理基础。方法：回顾性分析了28例经手术病理证实的MTC的CT表现，并与病理所见作对照研究。结果：肿瘤侵及一叶甲状腺22例，双叶6例。5例密度不均匀，23例表现为均匀低密度实质性占位（弥漫型19例）；25例增强扫描，17例原发灶轻度强化。淋巴结转移20例，其中行增强扫描的18例转移淋巴结多强化明显。对照病理，5例密度不均匀者镜下见囊变坏死（3例）或肿块内夹有未被侵犯的甲状腺组织（2例），而23密度均匀者未见上述改变，肿瘤组织中细胞分布大致均匀紧密，转移淋巴结内血管丰富。结论：MTC的CT表现以弥漫性均匀低密度肿块、轻度增强、多累及一叶甲状腺为特点，转移淋巴结以强化为特征。

Medullary thyroid carcinoma: evaluation of CT and pathologic findings

Objective To evaluate the CT features and pathologic findings of MTC. Methods The CT features of 28 patients with MTC confirmed pathologically were analyzed retrospectively and correlated with pathologic findings. Results The tumor invaded one lobe of the thyroid in 22 cases(78.6%), two lobe in 6 cases(21.4%). 5(17.9%) of them presented with heterogeneous hypodense masses and 23(82.1%) of them presented with homogeneous hypodense solitary masses . 20 patients had metastatic lymph nodes. The thyroid masses were enhanced slightly, while the lymph nodes were enhanced obviously. Correlating with pathologic findings, the heterogeneous lesions composed of cystic areas and/or necrosis, while the homogeneous lesions composed of homogeneously distributed tumor cells with no cystic areas or necrosis. The metastatic lymph nodes were hypervascular. Conclusion The CT features of MTC may be described as homogeneous diffuse hypodense mass, with slight enhancement,and invasion of one thyroid lobe in most cases. The metastatic lymph nodes are characterized with enhancement.