小松 誠, 横沢 保, 張 裕泰, 宮川 信, 飯田 太

Makoto KOMATSU, Tamotsu YOKOZAWA, Yu-tai CHANG, Makoto MIYAKAWA, Futoshi IIDA

信州大学医学部第二外科

Second Department of Surgery, Shinshu University School of Medicine

キーワード : Hot nodule, Thyroid carcinoma, Ultrasonography, <SUP>123</SUP>I scintigraphy

A patient with thyroid carcinoma showing a hot nodule on scintigram was examined by ultrasonography and was revealed to have carcinoma co-existed with adenomatous goiter.
The patient was a 52-year-old female who admitted Shinshu University Hospital because of a mass of the anterior neck. Physical examination revealed a round and firm nodule measuring 1.5×1.3 cm at the upper pole of the right thyroid lobe. ¹²³I scintigraphy revealed a hot nodule at the right lobe and a decrease of ¹²³I accumulation at the left lobe (Fig. 1a). After the TSH stimulation test, the left lobe showed an increased accumulation (Fig. 1b). The ultrasonographic findings of the nodule at the right lobe were summarized as low echoes, nonuniform of the internal structure, variable forms and undetectable capsule. The nodule was diagnosed as being thyroid carcinoma. Histologic examination of the removed specimen revealed papillary carcinoma surrounded with adenomatous goiter. Comparison of the scintigraphic and histologic findings suggested that the hot nodule was contributed to adenomatous goiter rather than carcinoma.