h******g
发帖数: 65 | 1 第一次在这里发贴， 不知道这样可以不
7月份b超是这样的，大家看看像不像恶性? 甲状腺双侧叶及峡部大小形体正常，被膜光
滑，腺体组织回声欠均匀，稍增粗，甲状腺左叶内见多处大小不等低等回声结节，较大
者位于腺体浅层，大小2.4*1.0cm,边界清晰。右叶中部深面似见0.7*0.4等回声结节，
边界欠清晰,CDFI上述结节周边可采集散在血流信号。左颌下见1.7*0.8淋巴结回声，左
颌下见2.1*0.9淋巴结回声。
8月份在国内另一家做的，想看一下那个大的变大没，没想到不同医院仪器不一样，没
法比较：甲状腺右叶1.79cm,峡部厚0.32cm,左叶厚1.89cm,实质回声增粗欠均，甲状腺
左叶可见中等回声结节，大小约2.36*1.15cm,边界尚清CDFI:期内可见血流信号显示，
左叶可见多个囊状回声及中强回声结节，较大者约1.1*1.0cm,甲状腺弥漫性改变。国内
这两个看着也不一样.
10月份回美国:
US THYROID OR NECK OR SOFT TISSUE
CLINICAL HISTORY: Palpable left thyroid nodule
TECHNIQUE: Static gray scale images are presented. Video clips are
presented.
COMPARISON: None.
FINDINGS:
The right neck shows no adenopathy. The right lobe of the thyroid
shows normal echotexture and architecture and dopplerable flow and
measure 5.7 x 1.5 x 1.97 cm.
Thyroid isthmus is thickened measuring 7 mm.
The left side of the neck shows no adenopathy. The left lobe of
thyroid measures 5.6 x 1.5 x 2.7 cm. There is a heterogeneous 11.2 x
6.4 x 8.8 mm solid and cystic nodule of the upper pole. There is a
hypoechoic solid 4.6 x 3.7 x 4.8 mm nodule of the mid gland. There is
a 7.6 x 5.3 x 7.4 mm hypoechoic solid nodule in the posterior aspect
of the lower pole. There is a dominant 2.6 x 1.4 x 2 cm isoechoic
mostly solid partially cystic nodule of the lower pole.
一周前最大的结节做了细针穿刺：
CLINICAL HISTORY:
Left lower pole thyroid nodule: 2.6 x 1.4 x 2.0 cm
SOURCE OF SPECIMEN:
THYROID, LEFT LOWER POLE, FINE NEEDLE ASPIRATION (FNA), RADIOLOGIC
__________________________________________________________________________
FINAL DIAGNOSIS:
THYROID, LEFT LOWER POLE, FINE NEEDLE ASPIRATION (FNA):
SATISFACTORY FOR INTERPRETATION.
FOLLICULAR NEOPLASM OR LESION
NPO/kmr
KMR/KMR
COMMENT:
The "Follicular Neoplasm or Lesion" category is applied to thyroid fine
needle
aspirates with the differential diagnosis including Follicular Adenoma,
Cellular Adenomatoid nodule in Goiter or Hashimoto's Thyroiditis, Well
Differentiated Follicular Carcinoma, Follicular Variant Papillary Carcinoma
and other well differentiated lesions such as parathyroid neoplasms. The
positive predictive value for this category is less than that of the
"Suspicious for Malignant Cells" category.
MODIFIED BETHESDA THYROID CYTOLOGY CLASSIFICATION (probability of malignant
outcome)
FOLLICULAR NEOPLASM OR LESION (20-30%)
(Bethesda equivalent: Suspicious for Follicular Neoplasm)
Reference:
Baloch ZW, et al. Diagn Cytopathol 2008;36: 425-37.
Layfield LJ, et al. Diagn Cytopathol 2009;37:710-4.
Nayar R, Ivanovic M. Cancer Cytopathol 2009;117:195-202.
Ali SZ, Cibas ES. The Bethesda System for Reporting Thyroid Cytopathology.
Definitions, Criteria and Explanatory Notes (Atlas). Springer 2010.
SEMIQUANTITATIVE DESCRIPTION OF CYTOLOGIC ELEMENTS
Background Colloid:
Small amount of colloid
Diagnostic (Follicular and/or other) Cellularity:
Numerous cell groups
Macrophages and other Inflammatory Cells:
Occasional macrophages or other inflammatory cells
怀疑滤泡甲状腺癌，但不确珍，只有手术。可不甘心切除因为有可能良性。有什么办法
么？
在国内时tsh很底， tg-ab很高，回美国后，tsh 正常偏高，刚生完孩子１２个月，是
不是产后甲状腺炎? 怕生第二胎再出现这个.
多谢！ | V**D
发帖数: 2869 | | h******g
发帖数: 65 | 3 I did FNA, and it is in the category "Follicular neoplasm". thanks.
【在 V**D 的大作中提到】
: 如果怀疑是癌，应该做活检。
| m**********r
发帖数: 2099 | 4 你好！
甲状腺双侧多发结节，RAIU是什么结果？根据upenn 2002年的研究，Follicular
Neoplasm中70%是良性。 | h******g
发帖数: 65 | 5 The doctor did not let me do RAIU. Yes, the doctor said it had 20-30% chance
of cancer, and she is doing another test from FNA and it might lower the
risk to 12%. The chance of cancer is always there, so the surgery is
recommended. :(
【在 m**********r 的大作中提到】
: 你好！
: 甲状腺双侧多发结节，RAIU是什么结果？根据upenn 2002年的研究，Follicular
: Neoplasm中70%是良性。
| l*h
发帖数: 4124 | 6 RAIU has little value in differentiating thyroid nodules in modern times.
chance
【在 h******g 的大作中提到】
: The doctor did not let me do RAIU. Yes, the doctor said it had 20-30% chance
: of cancer, and she is doing another test from FNA and it might lower the
: risk to 12%. The chance of cancer is always there, so the surgery is
: recommended. :(
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