Journal of Okayama Medical Association
Published by Okayama Medical Association

Full-text articles are available 3 years after publication.

リンパ節転移を伴う甲状腺癌を疑ったIgG4関連甲状腺炎(準確診群)の1 切除例

小橋 研太 済生会西条病院 外科
石井 博 済生会西条病院 外科
西山 加那子 愛媛大学医学部附属病院 乳腺センター
松三 雄騎 済生会西条病院 外科
羽田野 雅英 済生会西条病院 外科
藤原 雅光 今治医師会市民病院 外科
黒河 達雄 済生会西条病院 外科
常光 謙輔 済生会西条病院 外科
Thumnail 128_213.pdf 7.54 MB
 We present a case of probably IgG4-related thyroiditis with lymphadenopathy. The patient was a 70-year-old Japanese female who was undergoing hemodialysis and had undergone a right hemi-thyroidectomy in 1989 due to carcinoma. In December 2010, an ultrasonography study revealed a hypoechoic small lesion in thyroid gland. When the patient was admitted to our hospital in November 2013, the lesion and regional lymph nodes had enlarged and we suspected that they were metastatic thyroid cancer. We performed a residual total thyroidectomy and regional lymph node dissection in August 2014. At that time, lymphoplasmacytic infiltration and fibrosis were observed histopathologically in thyroid tissue. Immunohistochemical studies revealed infiltrated lymphocytes and plasma cells were markedly IgG-positive, and the ratio of IgG4-positive to IgG-positive cells was over 40%. We therefore diagnosed the patient with IgG4-related thyroiditis. The cervical lymph nodes were metastases of papillary carcinoma from 25 years earlier. The patient remains well without any recurrences 33 months after the surgery.
IgG4 関連甲状腺炎(IgG4-related thyroiditis)
橋本病(Hashimoto’s thyroiditis)
転移性リンパ節腫瘍(metastatic lymph node tumor)
慢性腎不全(chronic renal failure)
症例報告(Case Reports)