thyroid gland

甲状腺
  • 文章类型: Journal Article
    背景:改善原发性甲状腺神经鞘瘤(PTS)的特点,为临床诊治提供参考依据。
    方法:使用搜索词“甲状腺神经鞘瘤”或“甲状腺神经鞘瘤”或“甲状腺神经鞘瘤”搜索截至2022年12月的PTS病例报告,分别。筛查34例。
    结果:PTS可以发生在任何年龄,结节平均3.9厘米。最常见的症状是声音改变和吞咽困难。神经鞘瘤应考虑细针穿刺细胞学检查显示纺锤形细胞。大多数病例均行甲状腺叶切除术或结节切除术,预后良好。具有安东尼A和安东尼B特征的组织类型是常见的。S-100蛋白免疫组织化学染色阳性,CD34和波形蛋白有助于确认诊断。
    结论:S-100和波形蛋白的阳性免疫组化有助于确诊。术前诊断具有挑战性,但是病理和免疫组织化学染色是诊断的金标准。首选的治疗方法是手术切除结节,预后良好。
    BACKGROUND: To improve the characteristics of primary thyroid schwannomas (PTS) and to provide reference basis for clinical diagnosis and treatment.
    METHODS: PubMed was searched for case reports of PTS up to December 2022 using the search terms \"Thyroid nerve sheath tumor\" or \"Thyroid schwannoma\" or \"Thyroid Neurilemmoma\", respectively. 34 cases were screened.
    RESULTS: PTS can occur at any age, nodules averaged 3.9 cm. The most common symptoms were voice change and dysphagia. Fine needle aspiration cytology showing spindle-shaped cells should be considered for schwannoma. Most cases underwent thyroid lobectomy or nodule removal with a good prognosis. Tissue types with both Antoni A and Antoni B features are common. Positive immunohistochemical staining for S-100 protein, CD34 and waveform proteins helped confirm the diagnosis.
    CONCLUSIONS: Positive immunohistochemistry for S-100 and wave proteins helps confirm the diagnosis. Preoperative diagnosis is challenging, but pathology and immunohistochemical staining are the gold standard for diagnosis. The first choice of treatment is surgical resection of the nodules, the prognosis is good.
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    文章类型: Journal Article
    孤立性纤维瘤是一种相对罕见的软组织成纤维细胞瘤,约占软组织肿瘤的2%。它主要被描述为胸膜腔的肿瘤;然而,高达70%的病例发生在其他地方,在任何解剖位置,这会使诊断变得困难。如果这是正在考虑的诊断,STAT6抗体目前具有高灵敏度和特异性.在本文中,我们描述了一名72岁的女性患者的情况,随访并由门诊内分泌学家治疗甲状腺多结节性甲状腺肿。由于甲状腺左叶完全结节状重塑和甲状腺右叶几个小结节的超声检查结果,建议患者行甲状腺全切除术.该手术是在Jind之所以伊希夫Hradec医院的耳鼻喉科进行的。随后将手术材料送去进行组织病理学检查。显微镜下在甲状腺右叶发现了几个增生性胶体结节和一个小的嗜酸细胞腺瘤。在左叶,一个不精确的划定,在切片上观察到2x1.8x1.5cm的灰白色病变。微观上,肿瘤由局灶性透明基质中的纺锤形细胞组成。在免疫组织化学检查中,肿瘤细胞与CD34抗体呈阳性反应,对甲状腺球蛋白抗体呈阴性,细胞角蛋白(CKAE1/AE3)和S100蛋白。在较高机构咨询后,补充了具有阳性结果的进一步免疫组织化学检查(Bcl2,CD99,STAT6)。根据形态学和免疫组织化学检查结果,该肿瘤被诊断为甲状腺的孤立性纤维瘤。这在这个地方是一个相对不寻常的发现;根据文献,只描述了几十个案例。
    Solitary fibrous tumour is a relatively rare soft tissue fibroblastic tumour, accounting for approximately 2% of soft tissue tumours. It has been described primarily as a tumour of the pleural cavity; however, up to 70% of cases occur elsewhere, in any anatomical location, which can make diagnosis difficult. If this is the diagnosis being considered, the STAT6 antibody is currently available with high sensitivity and specificity. In this paper we describe the case of a 72-year-old female patient, followed up and treated by an outpatient endocrinologist for a multinodular euthyroid goitre for several years. Due to complete nodular remodelling of the left lobe of the thyroid gland and sonographic findings of several small nodules in the right lobe of the thyroid gland, total thyroidectomy was recommended to the patient. The operation was performed at the ENT department in Jindřichův Hradec Hospital. Material from the operation was subsequently sent for histopathological examination. Several hyperplastic colloid nodules and a small oncocytic adenoma were detected microscopically in the right lobe of the thyroid gland. In the left lobe, an imprecisely delineated, greyish-white lesion measuring 2 x 1.8 x 1.5 cm was observed on the section. Microscopically, the tumour consisted of spindle-shaped cells in a focally hyalinised stroma. In the immunohistochemical examination, tumour cells reacted positively with the CD34 antibody, and negatively with antibodies against thyroglobulin, cytokeratins (CK AE1/AE3) and S100 protein. Further immunohistochemical examinations (Bcl2, CD99, STAT6) with positive results were supplemented upon consultation at a higher facility. Based on morphology and the results of the immunohistochemical examinations, the tumour was diagnosed as a solitary fibrous tumour of the thyroid gland. This is a relatively unusual finding in this location; according to literature, only a few dozen cases have been described.
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  • 文章类型: Journal Article
    目的:本研究旨在探讨CT影像学特征,病理结果,与甲状腺乳头状癌(PTC)相关的甲状腺偏侧萎缩(THA)患者的预后。
    方法:这项回顾性研究包括225例经手术切除的组织病理学证实的PTC患者,他们接受了术前CT扫描。在CT图像上,THA被定义为PTC同侧的甲状腺实质萎缩。CT检查结果,总生存率,比较有和没有THA的患者的无病生存率。在有和没有THA的PTC中也评估了病理学发现。
    结果:在225例PTC患者中有35例(16%)观察到THA。在20例患者的右叶(57%)和其余15例患者的左叶(43%)中观察到萎缩性甲状腺实质。关于PTC内的固体组分,对比增强CT衰减(114.2±18.2vs.126.7±31.3HU;p<0.05),对比增强CT减去未增强CT的CT衰减变化(60.2±18.1vs.72.3±31.0HU;p<0.05)在有THA的PTC中明显低于无THA的PTC。组织病理学,几乎所有患有THA的PTC(97%)都有瘢痕疙瘩样胶原蛋白,这是广泛的低细胞胶原束,具有明亮的嗜酸性细胞性透明质化,通常在瘢痕疙瘩中观察到。然而,两组间的预后无显著差异.
    结论:在PTC患者中偶尔观察到THA。弱对比增强是PTC患者THA的显著特点,这可能是由瘢痕疙瘩样胶原蛋白引起的。
    OBJECTIVE: The present study aimed to investigate CT imaging features, pathological findings, and prognosis in patients with thyroid hemiatrophy (THA) associated with papillary thyroid carcinoma (PTC).
    METHODS: This retrospective study included 225 patients with histopathologically proven PTC treated by surgical resection who underwent preoperative CT scanning. On CT images, THA was defined as thyroid parenchymal hemiatrophy on the ipsilateral side of PTC. CT findings, overall survival, and disease-free survival were compared between patients with and without THA. Pathological findings were also assessed in PTCs with and without THA.
    RESULTS: THA was observed in 35 of 225 (16%) patients with PTC. Atrophic thyroid parenchyma was observed in the right lobe of 20 patients (57%) and in the left lobe of the remaining 15 patients (43%). With respect to the solid components within PTCs, contrast-enhanced CT attenuation (114.2 ± 18.2 vs. 126.7 ± 31.3 HU; p < 0.05) and CT attenuation change for contrast-enhanced CT minus unenhanced CT (60.2 ± 18.1 vs. 72.3 ± 31.0 HU; p < 0.05) were significantly lower in PTCs with THA than in those without THA. Histopathologically, almost all PTCs with THA (97%) had keloid-like collagen, which is broad bundles of hypocellular collagen with bright eosinophilic hyalinization, typically observed in keloid. However, no significant differences were observed in the prognosis between the two groups.
    CONCLUSIONS: THA was occasionally observed in patients with PTC. Weak contrast-enhancement was distinct characteristic of PTC patients with THA, which is probably caused by keloid-like collagen.
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  • 文章类型: Journal Article
    甲状腺的血液供应是许多原始研究的主题,病例报告和荟萃分析。在过去的几十年中,对甲状腺进行的外科手术的数量显着增加。尸体报告讨论了起源于头臂动脉的thryoideima动脉(TIA)在其最终细分之前的情况,向舌骨下肌肉释放许多分支,气管和甲状腺。根据目前的文献,我们讨论了TIA的患病率,它的胚胎学,以及这种变异可能的临床方面,特别注意术后并发症。
    Blood supply of the thyroid gland was the subject of numerous original studies, case reports and meta-analysies. The number of surgical procedures carried out on the thyroid gland significantly increases during last few decades. The cadaveric report discusses the case of a thryoidea ima artery (TIA) which originated from the brachiocephalic artery before its terminal subdivision, giving off numerous branches to the infrahyoid muscles, trachea and thyroid gland. Based on the current literature we discuss the prevalence of TIA, its embryology, and possible clinical aspects of this variation, with special attention paid to the postoperative complications.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    背景:炎性疾病通常是由病原体相关分子模式(PAMPs)和内源性损伤相关分子模式(DAMPs)触发的炎性体激活引发的,介导焦亡。尽管在桥本甲状腺炎(HT)患者中观察到甲状腺滤泡细胞(TFC)异常炎症体触发导致的焦亡,潜在的机制在很大程度上仍然未知。鉴于蛋白质泛素化和去泛素化在炎症性疾病中的广泛参与,我们旨在研究去泛素化酶如何调节甲状腺滤泡细胞焦凋亡和HT的发病机制.
    方法:我们的研究特别调查了泛素特异性肽酶1(USP1)的作用,去泛素酶(DUB),在调节炎症小体成分NLRP3和AIM2中,它们在焦亡中起着至关重要的作用。我们进行了一系列实验,以阐明USP1在促进与炎性体相关的焦亡和HT进展中的功能。这些实验涉及USP1敲低或抑制等技术,测量关键的焦亡指标,包括caspase-1,caspase-1p20和GSDMD-N,并使用小鼠模型检查USP1废除对HT的影响。此外,我们探讨了USP1对NLRP3转录的影响及其与p65核运输的潜在相互作用。
    结果:我们的研究结果提供了令人信服的证据,表明USP1通过去泛素化稳定NLRP3和AIM2,在促进炎性体介导的焦亡和HT进展中发挥关键作用。此外,我们发现USP1通过促进p65核运输来调节NLRP3的转录。USP1的敲低或抑制导致细胞焦亡减弱,正如caspase-1p20和GSDMD-N水平降低所证明的那样,可以在AIM2过表达后恢复。值得注意的是,USP1废除显著改善小鼠模型中的HT,可能用解热抑制剂VX-765和双硫仑治疗小鼠。
    结论:我们的研究强调了USP1在HT发病过程中对TFC中炎性小体活化和细胞凋亡的调节机制。这些发现扩展了我们对HT的理解,并表明抑制USP1可能是管理HT的潜在治疗策略。
    BACKGROUND: Inflammatory diseases are often initiated by the activation of inflammasomes triggered by pathogen-associated molecular patterns (PAMPs) and endogenous damage-associated molecular patterns (DAMPs), which mediate pyroptosis. Although pyroptosis resulting from aberrant inflammasome triggering in thyroid follicular cells (TFCs) has been observed in Hashimoto\'s thyroiditis (HT) patients, the underlying mechanisms remain largely unknown. Given the extensive involvement of protein ubiquitination and deubiquitination in inflammatory diseases, we aimed to investigate how deubiquitinating enzymes regulate thyroid follicular cell pyroptosis and HT pathogenesis.
    METHODS: Our study specifically investigated the role of Ubiquitin-specific peptidase 1 (USP1), a deubiquitinase (DUB), in regulating the inflammasome components NLRP3 and AIM2, which are crucial in pyroptosis. We conducted a series of experiments to elucidate the function of USP1 in promoting pyroptosis associated with inflammasomes and the progression of HT. These experiments involved techniques such as USP1 knockdown or inhibition, measurement of key pyroptosis indicators including caspase-1, caspase-1 p20, and GSDMD-N, and examination of the effects of USP1 abrogation on HT using a mouse model. Furthermore, we explored the impact of USP1 on NLRP3 transcription and its potential interaction with p65 nuclear transportation.
    RESULTS: Our findings provide compelling evidence indicating that USP1 plays a pivotal role in promoting inflammasome-mediated pyroptosis and HT progression by stabilizing NLRP3 and AIM2 through deubiquitination. Furthermore, we discovered that USP1 modulates the transcription of NLRP3 by facilitating p65 nuclear transportation. Knockdown or inhibition of USP1 resulted in weakened cell pyroptosis, as evidenced by reduced levels of caspase-1 p20 and GSDMD-N, which could be restored upon AIM2 overexpression. Remarkably, USP1 abrogation significantly ameliorated HT in the mice model, likely to that treating mice with pyroptosis inhibitors VX-765 and disulfiram.
    CONCLUSIONS: Our study highlights a regulatory mechanism of USP1 on inflammasome activation and pyroptosis in TFCs during HT pathogenesis. These findings expand our understanding of HT and suggest that inhibiting USP1 may be a potential treatment strategy for managing HT.
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  • 文章类型: Journal Article
    背景:经常在手术前给Graves病患者服用Lugol溶液。目的是减少甲状腺血管化和手术发病率,但是它的真正有效性仍然存在争议。本研究旨在评估术前Lugol溶液对接受全甲状腺切除术的Graves病患者甲状腺血管形成和手术发病率的影响。
    方法:56例接受Graves病甲状腺全切除术的患者被随机分配接受7天的Lugol治疗(Lugol组,29)或不使用Lugol治疗(LS-组,27)在这项单中心和单盲试验中的手术前。术前(T0)和手术当天(T1)收集术前激素和彩色多普勒超声检查数据,以评估甲状腺血管形成。主要结果是术中和术后失血。次要结果包括手术持续时间,甲状腺功能,发病率,血管化,和最终病理时的微血管密度。
    结果:人口统计学上没有差异,在T0时,LS+和LS-组之间发现了术前激素或超声检查数据。T1时,LS+组游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)水平较T0值明显降低,而在LS-组中没有观察到这种变化。两组超声血管形成的T0和T1之间均无差异,组织学发现也没有差异。LS+和LS-组之间术中/术后失血量无显著差异(中位数分别为80.5和94ml),手术时间(两组75分钟)或术后发病率。
    结论:Lugol溶液可显著降低Graves病手术患者的FT3和FT4水平,但不能减少术中/术后失血,甲状腺血管化,手术持续时间或术后发病率。
    背景:NCT05784792(https://www.clinicaltrials.gov)。
    BACKGROUND: Lugol solution is often administered to patients with Graves\' disease before surgery. The aim is to reduce thyroid vascularization and surgical morbidity, but its real effectiveness remains controversial. The present study was designed to evaluate the effects of preoperative Lugol solution on thyroid vascularization and surgical morbidity in patients with Graves\' disease undergoing total thyroidectomy.
    METHODS: Fifty-six patients undergoing total thyroidectomy for Graves\' disease were randomly assigned to receive 7 days of Lugol treatment (Lugol+ group, 29) or no Lugol treatment (LS- group, 27) before surgery in this single-centre and single-blinded trial. Preoperative hormone and colour Doppler ultrasonographic data for assessing thyroid vascularization were collected 8 days before surgery (T0) and on the day of surgery (T1). The primary outcome was intraoperative and postoperative blood loss. Secondary outcomes included duration of surgery, thyroid function, morbidity, vascularization, and microvessel density at final pathology.
    RESULTS: No differences in demographic, preoperative hormone or ultrasonographic data were found between LS+ and LS- groups at T0. At T1, free tri-iodothyronine (FT3) and free thyroxine (FT4) levels were significantly reduced compared with T0 values in the LS+ group, whereas no such variation was observed in the LS- group. No differences between T0 and T1 were found for ultrasonographic vascularization in either group, nor did the histological findings differ. There were no significant differences between the LS+ and LS- groups concerning intraoperative/postoperative blood loss (median 80.5 versus 94 ml respectively), duration of surgery (75 min in both groups) or postoperative morbidity.
    CONCLUSIONS: Lugol solution significantly reduces FT3 and FT4 levels in patients undergoing surgery for Graves\' disease, but does not decrease intraoperative/postoperative blood loss, thyroid vascularization, duration of surgery or postoperative morbidity.
    BACKGROUND: NCT05784792 (https://www.clinicaltrials.gov).
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  • 文章类型: Journal Article
    甲状腺细胞学是一个快速发展的领域,近年来取得了重大进展。其主要目标是准确诊断甲状腺结节,区分良性和恶性病变,当无法明确诊断时,对结节进行风险分层。甲状腺细胞学的当前景观包括使用细针抽吸术诊断甲状腺结节,分层报告系统,如贝塞斯达甲状腺细胞病理学报告系统。近年来,分子检测已成为一种可靠的术前诊断工具,可将患者分为不同的风险类别(低,中间,或高)具有不同的恶性肿瘤概率,并有助于指导患者治疗。
    Thyroid cytology is a rapidly evolving field that has seen significant advances in recent years. Its main goal is to accurately diagnose thyroid nodules, differentiate between benign and malignant lesions, and risk stratify nodules when a definitive diagnosis is not possible. The current landscape of thyroid cytology includes the use of fine-needle aspiration for the diagnosis of thyroid nodules with the use of uniform, tiered reporting systems such as the Bethesda System for Reporting Thyroid Cytopathology. In recent years, molecular testing has emerged as a reliable preoperative diagnostic tool that stratifies patients into different risk categories (low, intermediate, or high) with varying probabilities of malignancy and helps guide patient treatment.
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  • 文章类型: Journal Article
    内分泌系统,特别是甲状腺激素及时调节所有脊椎动物的几乎所有生理过程,从鱼类到爬行动物再到哺乳动物,因此,鉴于内分泌干扰化学物质(EDCs)在所有环境基质中的持续存在,对其进行风险评估极为重要。间苯二酚,以及壬基酚,辛基苯酚,和双酚A,F,S,是被称为EDC的非卤化酚类(非HPCs)化学品。间苯二酚是一个特别的例子,因为大多数研究完全基于人类,而动物研究很少,而且往往不充分。这项研究的目的是评估在甲状腺活动周期的不同时期暴露于不同剂量的间苯二酚对蜥蜴Podarcissiculus甲状腺的影响。我们的结果显示甲状腺的组织病理学改变(滤泡细胞高度增加和胶体面积减少),甲状腺体重增加与血清T4和T3降低相结合,血清TSH,用0.8、3.9、13.1和36.9mg/kg/d间苯二酚处理的雄性蜥蜴的TRH增加。此外,我们还研究了间苯二酚治疗对肝脏5'ORD(II型)脱碘酶和肝脏T3和T4含量的影响.我们的研究结果表明,它们与人体和啮齿动物的体内数据一致,因此,爬行动物中的间苯二酚可能符合WHO对ECD的定义。
    The endocrine system and particularly thyroid hormones regulate almost all physiological processes in a timely manner in all vertebrates, from fish to reptiles to mammals, so risk assessment of endocrine disrupting chemicals (EDCs) is extremely important given their persistent presence in all environmental matrices. Resorcinol, as well as nonylphenol, octylphenol, and bisphenol A, F, S, are non-Halogenated Phenolic (non-HPCs) Chemicals known as EDCs. Resorcinol is a particular example in that most studies are based exclusively on humans while animal studies are few and often inadequate. The aim of this study was to assess the effects of exposure to different doses of resorcinol on the thyroid gland of the lizard Podarcis siculus during different periods of the thyroid gland activity cycle. Our results showed histopathologic changes in thyroid (follicular cell height increase and colloid area decrease), a thyroid weight increase in combination with serum T4 and T3 decrease, serum TSH, TRH increase in male lizards treated with 0.8,3.9,13.1, and 36.9 mg/kg/d of resorcinol. Besides, we also investigated the impacts of resorcinol treatments on hepatic 5\'ORD (type II) deiodinase and hepatic content of T3 and T4. Our findings showed that they are in agreement with in vivo in humans and in rodents data and therefore, resorcinol in reptiles may meet the WHO definition of ECDs.
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  • 文章类型: Journal Article
    甲状腺功能通过饮食-肠-甲状腺轴与营养密切相关。这篇叙述性综述强调了营养成分和微量营养素对甲状腺发育和功能的影响。以及肠道微生物群。微量营养素如碘,硒,铁,锌,铜,镁,维生素A,和维生素B12影响甲状腺激素的合成和调节整个生命。饮食变化可以改变肠道微生物群,不仅导致菌群失调和微量营养素缺乏,而且通过免疫调节导致甲状腺功能的变化,营养吸收,和表观遗传变化。营养失衡可导致甲状腺功能障碍和/或疾病,比如甲状腺功能减退和甲状腺功能亢进,并可能导致自身免疫性甲状腺疾病和甲状腺癌,但有争议的问题。了解这些关系对于合理化富含必需微量营养素的均衡饮食对于维持甲状腺健康和预防甲状腺相关疾病非常重要。对当前知识的综合综合概述显示了微量营养素和肠道微生物群对甲状腺功能的重要性,并揭示了需要进一步研究的潜在差距。
    Thyroid function is closely linked to nutrition through the diet-gut-thyroid axis. This narrative review highlights the influence of nutritional components and micronutrients on thyroid development and function, as well as on the gut microbiota. Micronutrients such as iodine, selenium, iron, zinc, copper, magnesium, vitamin A, and vitamin B12 influence thyroid hormone synthesis and regulation throughout life. Dietary changes can alter the gut microbiota, leading not just to dysbiosis and micronutrient deficiency but also to changes in thyroid function through immunological regulation, nutrient absorption, and epigenetic changes. Nutritional imbalance can lead to thyroid dysfunction and/or disorders, such as hypothyroidism and hyperthyroidism, and possibly contribute to autoimmune thyroid diseases and thyroid cancer, yet controversial issues. Understanding these relationships is important to rationalize a balanced diet rich in essential micronutrients for maintaining thyroid health and preventing thyroid-related diseases. The synthetic comprehensive overview of current knowledge shows the importance of micronutrients and gut microbiota for thyroid function and uncovers potential gaps that require further investigation.
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