RESUMEN
Objective To study the diagnosis of chronic lymphocytic thyroiditis (CLT), and the treatment of CLT companied with other thyroid diseases. Methods Clinical data of 63 cases of CLT were analyzed retrospectively. Results 26 cases were diagnosed by non-operative methods (11 cases by fine needle aspiration biopsy, FNAB). The rest of 37 cases were operated on because of misdiagnosis as other thyroid disease and then comfirmed as CLT by pathology. Of them, 2 were companied with nodular goiter, 6 with Graves' disease, 1 with thyroid adenoma and 2 with carcinoma, respectively. 19 cases were treated by thyroixine, 3 were not treated, 4 treated by operation after thyioxine managment and 37 were treated by operation. Non-operation group had rather satisfied effect in short-term period. 29 cases (78.4%) in operation group were followed up for 1 to 6 years, and 5 cases had hypothyroidism. Conclusions It is necessary to have complete serum immunologic examination and FNAB for suspect patients.They have to be examined carefully in order to avoid omitting complications and incsease the rate of diagnosis.Non-operative treatment is the major therapy of CLT. If CLT is companied with other thyroid disease, operation or non- operation should be adopted according to the pathological type.
RESUMEN
Objective To investigate the characteristic, diagnosis and treatment of occult breast carcinoma(OBC). Methods The clinical data of 12 cases of OBC were analyzed retrospectively.Results All patients showed axillary node enlargement as the first sign and were operated on. The operation included axillary node excision (ANE) in 1 patient, axillary node excision plus simple mastectomy in another one, radical mastectomy in 6, and modified radical mastectomy in the other 4,respectively. Eleven patients (91.7%) were followed up for 1-15 years. During the follow up, 1 patient who underwent axillary node resection and 1 who received ANE plus simple mastectomy died of systemic metastasis,18 and 22 months after operation respectively;another case who subjected to radical mastectomy had axillary lymph node metastasis 3 years after the operation,and was re operated on,but the patient died of lung metastasis 4 years after the reoperation. And the others still survived, in which 2 have lived for over 3 years, 2 over 5 years, and 4 over 10 years. Conclusions For axillary mass which causes are uncertain, the possibility of OBC should be considered.Meanwhile excision and pathological examination are necessary. The metastatic histological structure of the axillary nodes usually provide important clue for the source of tumor. Radical or modified mastectomy is the best treatment,and post operative chemotherapy and/or radiotherapy should be done.