甲状腺癌淋巴结转移的CT表现

·头颈部放射学·甲状腺癌淋巴结转移的CT表现
罗德红　石木兰　李复
【摘要】　目的　评价甲状腺癌淋巴结转移的CT特点。

方法　回顾性分析经手术及病理诊断的
108例甲状腺癌淋巴结转移的CT表现。

结果　108例中，颈上中深组淋巴结转移76例，颈下深组及
锁骨上窝86例，气管食管沟52例，纵隔17例。

84例乳头状癌中，16例淋巴结密度与正常甲状腺相
似，24例有囊性变，其中18例淋巴结囊内有明显强化的乳头状结节，11例有细颗粒状钙化。

24例滤
泡癌、髓样癌、透明细胞癌中，17例淋巴结明显强化，17例与甲状腺原发或复发肿瘤密度一致，密度均
匀或不均匀。

结论　甲状腺癌转移淋巴结好发部位为颈静脉链周围、气管食管沟及纵隔；淋巴结明显
强化、与正常甲状腺密度一致、囊性变、囊壁内明显强化的乳头状结节及细颗粒状钙化为甲状腺乳头
状癌的特征性改变；淋巴结明显强化、与甲状腺肿瘤密度一致为滤泡癌、髓样癌、透明细胞癌转移淋巴
结的特点。

【关键词】　甲状腺肿瘤；　淋巴结转移；　体层摄影术，X线计算机
CT manifestations of lymph node metastasis of thyroid carcinoma LUO Dehong *, SHI Mulan, LI Fu.
*Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing 100021, China
【Abstract】 Objective To study the CT manifestations of metastatic lymph node of thyroid carcinoma.
Methods CT appearances of metastatic lymph node of thyroid carcinoma proved by surgery and pathology in 108
patients were reviewed. Results Of these 108 cases, metastatic lymph nodes were located at superoir and middle
internal jugular chain (n=76), inferior internal jugular chain and super clavicular region (n=86), tracheoesophageal groove (n=52), and superior mediastinum (n=17). Of 84 thyroid papillary carcinoma
patients, the attenuation of metastatic lymph nodes were similar to that of normal thyroid gland (n=16), with
cystic formations (n=24), intracystic high attenuation papillary-like nodules (n=18), and fine granular
calcifications (n=11). Of 24 follicular carcinoma, medullary carcinoma, and clear cell carcinoma patients, 17
cases had significant homogeneous or heterogeneous enhanced nodes, and the attenuation was the same as primary
or recurrent thyroid tumors. Conclusion For thyroid carcinoma, the most common locations of metastatic lymph
nodes were internal jugular chain, tracheoesophageal groove, and superior mediastinum regions. Marked
enhancement similar to normal thyroid gland, cystic formations with intracystic high attenuation papillary-like
nodules, and fine discrete granular calcifications were the characteristic manifestations of metastatic lymph node of
papillary carcinoma. Marked homogeneous or heterogeneous enhancement after contrast administration and the same
attenuation as the primary or recurrent thyroid tumor were found in follicular carcinoma, medullary carcinoma, and
clear cell carcinoma metastases.
【Key words】 Thyroid neoplasms; Lymph node metastasis; Tomography, X-ray computed
作者单位：100021北京，中国医学科学院中国协和医科大学肿
瘤医院放射诊断科（罗德红、石木兰）；辽宁省瓦房店市中心医院C T
室（李复）。