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1 病例报告患者,男,54岁.因颈前无痛性包块2个月,明显增大1周,于1996年8月13日入院.患者于入院前2个月无明显诱因感颈前区胀痛,手触摸发现一约杏核大小的包块.胀痛持续2天自行缓解,无发热、咳嗽、咳痰、咽痛等症状.查体:右侧甲状腺下极可触及一2cm×3cm大小的包块,轻度压痛,质硬,活动度差.气管居中,左甲状腺1度肿大.B超检查:甲状腺右叶有一约2.7cm×2.1cm实性占位,边界欠清晰.放射性核素I检查:吸碘率低于正常值范围.胸部X线片:肺及气管未见异常.病理检查 大体所见:灰褐色不规则形肿物一块,大小5cm×3cm×2.5cm,无明显包膜,切面灰白灰褐色,肿物与甲状腺界限不清.镜下;肿瘤组织将甲状腺正常组织结构破坏,癌细胞呈小巢状、片状、条索状分布,癌细胞大小不一,呈多角形、类圆形、核大,染色深,部分细胞胞浆丰富,呈角化倾
1 case report patient, male, 54 years old. Painless mass in front of the neck for 2 months, an increase of 1 week, admitted to hospital on August 13, 1996. The patient had no significant incentive before the neck 2 months before admission District pain, hand touch found a size of apricot nuclear mass. Pain relief for 2 days to ease, no fever, cough, sputum, sore throat and other symptoms. Physical examination: the right lower thyroid can touch a 2cm × 3cm size mass, mild tenderness, hard, poor activity. Central trachea, 1 degree left thyroid enlargement. B-ultrasonic examination: the right thyroid gland has a solid mass of about 2.7cm × 2.1cm, the boundary is less clear. Radionuclide I examination: iodine absorption rate is lower than the normal range. Chest X-ray: no abnormalities in the lungs and trachea. Pathological examination generally seen: gray-brown irregular shaped mass, size 5cm × 3cm × 2.5cm, No obvious capsule, gray-brown cross-section, tumor and thyroid boundaries unclear. Microscopic; tumor tissue will destroy the normal structure of the thyroid gland, cancer cells were small nests, sheets, strips distribution, cancer cells of different sizes , Polygonal, round in shape, large in nucleus, dark in color, abundant in cytoplasm, showing keratosis