ABSTRACT
Objective To investigate the diagnosis and treatment of hashimoto′s disease(HD) complicated with thyroid adenomas(TA).Methods Clinical data of 50 cases of HD complicated with TA were analysed retrospectively. Results 8 patients were diagnosed before operation ,misdiagnosis rate was 84.0%.Intra operation frozen section diagnosis rate was 81.4% (35/43).All patients were diagnosed as HD complicated with TA by pathology after operation.Various extension thyroidectomies were performed according to the patients conditions. After operation,27 cases were given small dosage of thyroxine and 2 cases were given small dosage of prednisone. All the 50 patients were followed up for 3 months to 1 year, none presented hypothyroidism.Conclusions Complete serum immunologic examinations,ultrasonography and fine needle aspiration biopsy are helpful for the diagnosis of HD with TA. HD with TA should be treated surgically,and the intraoperation frozen section for the diagnosis is important.The operation procedures,extension of excision and medication after operation should be individulization to avoid the occurrence of postoperative hypothyroidism as possible.
ABSTRACT
Objective To investigate the diagnosis and surgical management of Hashimoto's thyroiditis and coexisting disease. Methods The clinical data of 54 patients with Hashimoto's thyroiditis were analyzed retrospectively. Results 25 cases were diagnosed as Hashimoto's disease by clinical physical examination, FNAB and immune antibody assay. Diagnostic treatment with medicine was adopted firstly. Of them 24 cured, one was found coexisting thyroid cancer, and then a radical operation was performed. The other 29 cases had been misdiagnosed as surgical diseases because of atypical features and undergoing thyroidectomy; the diagnosis of Hashimoto's disease had been confirmed by pathology, and some coexistence had been found(hyperthyroidism in 3, thyroid carcinoma in 4, malignant lymphoma in 2, thyroid adenoma in 5). Conclusions Attention should be paid to the atypical Hashimoto's disease. FNAB, immune antibody assay, diagnostic treatment, operative exploration and biopsy would be helpful to make the sound diagnoses of Hashimoto thyroiditis and the disease in coexistence, which ought to be operated on corresopondingly.