小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 可触及的甲状腺结节
其他诊断因素
- 成年期初期
- 甲状腺癌家族史
- 声嘶
- 呼吸困难
- 吞咽困难
- 气管偏斜
- 颈部淋巴结肿大
- 快速的颈部肿大
危险因素
- 头颈部放射治疗
- 女性
- 甲状腺癌家族史
诊断性检查
首要检查
- TSH
- 颈部超声
- 细针穿刺活检
需考虑的检查
- 细胞学样本的分子分析
- 游离 T4
- 游离T3
- 喉镜检查
- I-123 甲状腺扫描和摄取
- 粗针活检
- 颈部 CT 扫描
- 血清降钙素
- 家族性综合征患者行基因检测
新兴检查
- 经喉超声
- 前哨淋巴结活检
治疗流程
乳头状、滤泡状或 Hürthle 细胞癌
未分化癌
髓样癌
原发性甲状腺淋巴瘤
撰稿人
作者
Rajiv Datta, MD, FACS, FRCS, FICS
Chairman
Department of Surgery
Professor Of Surgery, Icahn School of Medicine at Mount Sinai
Chief
Division of Surgical Oncology
Chief
Division of Head and Neck Surgery
Mount Sinai South Nassau Hospital
Oceanside
NY
利益声明
RD declares that he has no competing interests.
同行评议者
Rosemarie Metzger, MD, MPH, FACS
Associate Professor of Surgery, Endocrine Surgery Division
Banner - University Medical Center
Phoenix
AZ
利益声明
RM declares that she has no competing interests.
Lindsay Bischoff, MD
Associate Professor
Medical Director Vanderbilt Thyroid Center
Vanderbilt University Medical Center
Nashville
TN
利益声明
LB declares that she has no competing interests.
F. Fausto Palazzo, MS, FRCS
Consultant Endocrine Surgeon
Hammersmith & Charing Cross Hospitals
Clinical Lead for Endocrine Surgery
Honorary Senior Lecturer
Imperial College
London
UK
利益声明
FFP declares that he has no competing interests.
鉴别诊断
- 良性甲状腺结节
更多 鉴别诊断指南
- NCCN肿瘤临床实践指南：甲状腺癌
- 实践参数：甲状腺和颅外头颈诊断超声的性能和解读
更多 指南
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明