甲状腺癌の臨床病理学的研究
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The data forming the basis of this report were obtained from a study of the clinical records and pathologic speciment of eightynine patients from whom thyroid carcinoma was surgically removed during January 1951 to August 1968 at the First Department of Surgery, Chiba University. The classification of the lesion in this series was as follows: fiftynine cases have had papillary adenocarcinoma, sixteen cases follicular adenocarcinoma, fifteen cases anaplastic carcinoma and only one case Hurthle cell carcinoma. In eightynine patients with thyroid carcinoma, seven cases of small carcinoma less than 1.5cm in diameter were revealed by histologic examination. These facts, therefore, appear to need that many sections in each specimen are examined carefully. Histologic stages of fiftysix cases of thyroid carcinoma were classified as malignant lesions within capsule of the tumor, and cancerous invasion both within thyroid gland and of surrounding tissue. Thirty cases (53.6%) had invasion within thyroid gland, sixteen cases (28.5%) invasion of surrounding tissue and ten cases (17.0%) within capsule. In all cases of follicular adenocarcinoma and anaplastic carcinoma, infiltration out of capsule was revealed by histologic examination. It is of interest that fourteen cases (10.2%) in 137 cases of benign thyroid adenoma without degenerative thyroid cysts were found of capsular invasion and 11 cases (8.0%) found of vascular invasion. In eightynine patients with thyroid carcinoma, seventynine cases were females and ten cases were males. These thyroid carcinoma were most frequent during third to fourth decade, but younger patients less than twentynine years old were thirteen cases (14.6%). Diagnosis of thyroid carcinoma was discussed. In many instances, irregular margin of cold nodule in radioactive Iodine thyroid scintigram, deviation and stenosis of trachea in X-ray examination and uptake of radioactive Phosphate in tumor were characteristic findings which had best served on diagnosis of thyroid carcinoma. However, just fiftynine cases (66.2%) were diagnosed as thyroid carcinoma by clinical examination. A large number of patients with thyroid carcinoma was performed extirpation of tumor, lobectomy or semitotal thyroidectomy. Of fourtytwo patients who have been followed five or more years or until dead since initial operation, thyroid carcinoma had interesting implications for the histologic type of carcinoma. Ninetyfour per cent in thirtyfour cases with papillary adenocarcinoma are survived, seventyfifve per cent in four cases with follicular adenocarcinoma suvived more than five years. While no patient with anaplastic carcinoma survived. The prognosis of thyroid carcinoma was related with size of tumor, metatstasis of cervical lymph node and age.
- 千葉大学の論文
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