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患男,54岁,发现颈部包块10年,增大伴胀痛10d就诊。病后无发热、咳嗽、盗汗,否认结核病史。查体:T36.9℃,P88次/min,BP12/8kPa,一般情况好,左颈部淋巴结肿大,气管稍右移,甲状腺左叶可触及4cm×3cm圆形包块,质硬,活动度差,心肺(-)。B超:左侧甲状腺内后方可探及13.4mm×17.7mm及41.3mm×23.1mm两个混合性光团,周边为强光点回声,其后声影明显;提示:左叶甲状腺腺瘤并出血坏死。胸片正常。颈部正侧吸气位平片示:气管右移。C_5及C_7处显示软组织包块伴有广泛钙化,肿块约5cm×5cm大小。甲状腺扫描:左叶上极、中段冷结节;CEA300ng/L;入院诊断:甲状腺腺瘤伴出血。
Male, 54 years old, found the neck mass 10 years, increased pain with 10d treatment. After the illness without fever, cough, night sweats, denied a history of tuberculosis. Physical examination: T36.9 ℃, P88 times / min, BP12 / 8kPa, generally good, the left cervical lymph nodes, right tracheal shift, thyroid left lobe can reach 4cm × 3cm round mass, hard, activity Degree of poor, cardiopulmonary (-). B ultrasound: the left thyroid in the rear can be explored and 13.4mm × 17.7mm and 41.3mm × 23.1mm two mixed light group, the surrounding light point echo, followed by sound shadow significantly; Tip: Left lobe thyroid adenoma with Hemorrhagic necrosis. Normal chest X-ray. Positive suction side of the neck flat film shows: trachea right. C_5 and C_7 Department showed soft tissue mass with extensive calcification, mass about 5cm × 5cm size. Thyroid scan: the left upper pole, middle cold nodules; CEA300ng / L; admission diagnosis: thyroid adenoma with hemorrhage.