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Objective:To analyze the clinical characteristics and surgical treatment of patients with cervical bronchogenic cyst.Methods:This study enrolled 14 cases of cervical bronchogenic cysts confirmed by surgery and pathology in our hospital from Sep 2015 to Sep 2020 to discuss clinical, imaging features and diagnosist.Results:Cysts lay in the left neck in 8 cases and in the right side in 6 cases, with the largest diameter of 5.8 cm and the smallest of 0.8 cm (3.4±1.7) cm. Cysts were closely related to the thyroid in 10 cases, adjacent to the recurrent laryngeal nerve in 2 cases. The postoperative pathology established the diagnosis of bronchogenic cyst, and no patients suffered from recurrence during the follow-up period.Conclusions:Cervical bronchogenic cyst is a rare congenital malformation of extrathoracic bronchogenic cyst. Final diagnosis is dependent upon pathology. Complete surgical resection is the key to prevent recurrence.
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Objective:To summarize the ultrasound features of medullary thyroid cancer (MTC) and analyze its diagnosis value for MTC.Methods:91 patients with medullary thyroid carcinoma (103 nodules) in Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from Apr. 2013 to Nov. 2018 were retrospectively analyzed, including 36 males and 55 females. Preoperative ultrasound features and serum calcitonin levels were recorded. SPSS 22.0 was used and the measurement data of normal distribution was expressed as ± s, and the enumeration data was described by ratio or rate. The comparison between groups was performed by single factor ANOVA and rank sum test. Results:83.5% (86/103) of the MTC nodules were located in the middle and upper thyroid gland. Hypoechoic accounted for 78.6% (80/103) . 81.6% (84/103) of them had calcification and 74.8% (77/103) of these nodules had abundant blood flow signals (color Doppler flow imaging, CDFI Ⅱ-Ⅲ) . 91.3% (94/103) of them had aspect ratio less than 1, 87.4% (90/103) were solid and 35.0% (36/103) had comet tail sign. The positive rate of preoperative serum calcitonin was 86.8% (79/91) . There were significant differences in shape ( P=0.001) , margin ( P=0.012) , cystic ( P=0.004) , comet-tail ( P<0.001) , lymph node ( P<0.001) and color Doppler flow imaging ( P=0.001) through comparing MTC nodules in different TI-RADS grades. Conclusions:MTC can behave as single, solid, hypoechoic, large round nodule located in the middle or upper thyroid gland, with thick calcification and abundant blood flow signals in ultrasound. The surrounding area may be accompanied with comet tail sign, and the probability of lymph node metastasis is high. The suspicious nodules screened by ultrasound can be further diagnosed by serum calcitonin.
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Objective To explore the clinical diagnosis and treatment of hyperthyroidism patients coexisted thyroid carcinoma.Methods A retrospective analysis was made in 15 cases with hyperthyroidism patients coexisted thyroid carcinoma who were operated from Nov.2008 to Dec.2017 in Department of General Surgery of Jian'an District Peoples' Hospital.Results The incidence of hyperthyroidism patients coexisted thyroid carcinoma was 8.19％(15/183) in our study.All 15 patients included 12 papillary thyroid carcinoma,1 follicular thyroid carcinoma,1 medullary thyroid carcinoma,and 1 follicular papillary carcinoma.Among them,papillary thyroid microcarcinoma accounted for 66.67％(10/15).All 15 postoperative patients were followed up and the mean time was 13.25 months.Neither recurrence nor mortality occurred during the period.Conclusions Hyperthyroidism patients coexisted thyroid carcinoma have no characteristic clinical manifestations or specific diagnosis indicators.The prognosis can be good through strengthening awareness,improving vigilance,comprehensive analysis and surgical treatment.
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Objective To explore the clinical features, diagnosis and treatment of ectopic thyroid gland and to improve the management of ectopic thyroid. Methods The clinical data of 15 cases of ectopic thyroid in our hospital and the literatures were analyzed. The clinical features of ectopic thyroid gland, its diagnosis and the treatment were summarized. Results Of the 15 cases, 13 cases underwent operation. Among them, 9 cases showed symptom relief and their thyroid gland function resumed normal with no reoccurrence, 3 cases were complicated by temporary hypothyroidism and 1 case was misdiagnosed and mistreated, resulting in permanent hypothyroidism and lifetime thyroid hormone replacement. Conclusions Ectopic thyroid gland is a rare disease which was frequently misdiagnosed and mistreated. Improvement of related examination is essential in reducing misdiagnosis and mistreatment.
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Purpose:To investigate the expression and clinical significance of estrogen receptor and Cyclin D1 in the differentiated thyrord carcinoma. Methods:We investigated the expression of ER and Cyclin D1 in thyroid normal tissue, thyroid adenoma and DTC by SP immunohistochemical technique. We have collected 89 specimens from surgical resections, and all the sections were formalin-fixed and paraffin-embedded, each has detailed clinical data, two pathologists classified the histopathologic types. DTC 43 cases (papillary thyroid carcinoma, 39 cases, follicular thyroid carcinoma, 4 cases); thyroid follicular adenoma 30 cases, and 16 cases of normal thyroid tissues taken from around the thyroid adenoma. Results:The positive rates of ER and CyclinD1 in the DTC were 53.5%(23/43), 65.1%(28/43) respectively; the positive rates of ER and CyclinD1 in the thyroid adenoma were 26.7%(8/30), 36.7%(11/30) respectively; the positive rates of ER in normal thyroid tissues were 12.5%(2/16), while CyclinD1 were negative. The ER expression in DTC was significantly higher than that in the thyroid adenoma and the normal thyroid tissues(P
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Objective To study the mechanism and management of abdominal compartment syndrome (ACS) in patients with Budd Chiari Syndrome (BCS).Methods 42 patients with BCS complicated with ACS were diagnosed by venography and intraabdominal pressure measurement. All patients were treated with ascities dialysis and influsion before operation. Portosystemic shunt was performed on 36 patients, and interventional procedures were conducted to recanalize the occluded main hepatic vein(MHV) on 6 patients. Results In this series, 2 patients died postoperatively and 2 patients had no good results in long term follow-up; the clinical features disappeared or markedly alleviated in the others. Conclusions MHV occlusion is the primary pathologic change of BCS complicated with ACS. Portosystemic shunt operation or MHV recanalization by interventional therapy can relieve the symptoms of BCS with ACS.
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Objective To study new preoperative preparation for primary hyperthyroidism. Methods Before operation, Lugol solution was used(5～10 getts/time, 3 times/d) for 10 days. On the 7th day, dexamethasone 20?mg was added to 5%～10% glucose solution 500?ml was consecutively used for 3 days before the operation. Results FT 3 fell to normal value after dexamethasone 20?mg was used once, and FT 4 fell to normalvalue after dexamethasone used 3 days. There was no any complication, such as thyroid crisis occurring in this series. Conclusions Dexamelhasone applied before operation as the preoperative preoparation for primary hyperthyroidism is testified a safe and effective method.
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Objective To study the mechanism and management of abdominal compartment syndrome (ACS) in patients with Budd Chiari Syndrome (BCS).Methods 42 patients with BCS complicated with ACS were diagnosed by venography and intraabdominal pressure measurement. All patients were treated with ascities dialysis and influsion before operation. Portosystemic shunt was performed on 36 patients, and interventional procedures were conducted to recanalize the occluded main hepatic vein(MHV) on 6 patients. Results In this series, 2 patients died postoperatively and 2 patients had no good results in long term follow-up; the clinical features disappeared or markedly alleviated in the others. Conclusions MHV occlusion is the primary pathologic change of BCS complicated with ACS. Portosystemic shunt operation or MHV recanalization by interventional therapy can relieve the symptoms of BCS with ACS.