1 Thyroid cancer-FNA 내분비대사내과
김 0 자 (F/57) C.C : known thyroid mass o/s) 1 개월 전 P.I : 평소 건강히 지내던 환자로 내원 1 개월 전 건강검진 위해 시 행한 thyroid sono 에서 mass 관찰되어 further evaluation 위 해 내원함. PMHx : DM/HTN/TB/hepaitits (-/-/-/-), 가족력 (-) ROS : fever (-), weight loss (-), sweating (-) heat or cold intolerance (-), agitation (-) A/N/V/C/D (-/-/-/-/-) P/Ex : thyroid mass (+) size : 2x2cm location : Rt. Lobe (lower) margin : well defined bruit/thrill (-/-) consistency : hard tenderness : (-) movable(-) Case 1
3 CBD/DC /mm 3 – 12.8 g/dL – Hct 40.9%- PLT /mm 3 TB/DB 1.01/0.25 mg/dL Prot/Alb 6.8/3.9 g/dL AST/ALT 25/27 U/L BUN/Cr 9/0.5g/dL Na/K/Cl 141/4.1/103 mmol/L Ca/P 9.1/4.5 mg/dL T3 150 ng/dL (80~200) FT ng/dL (0.8~1.8) TSH 1.03 μU/mL (0.4~3.1)
4 Thyroid sonography
5
6
7 Pathology Papillary carcinoma Total thyroidectomy
안 0 분 (F/49) C.C : known thyroid mass o/s) 1 년 전 P.I : 평소 건강히 지내던 환자로 내원 1 년 전 본원에서 시행한 thyroid sono 에서 mass 관찰 되어 시행한 FNA 에서 benign follicular lesion 나와 외래추적 관찰 중으로 F/U throid sono 위 해 내원함. PMHx : DM/HTN/TB/hepaitits (-/-/-/-), 가족력 (-) ROS : fever (-), weight loss (-), sweating (-) heat or cold intolerance (-), agitation (-) A/N/V/C/D (-/-/-/-/-) P/Ex : thyroid mass (-) size : non-palpable tenderness : (-) bruit/thrill (-/-) Case 2
9 CBD/DC 7710 /mm 3 – 13.0 g/dL – Hct 38.1%- PLT /mm 3 TB/DB 1.25/0.12 mg/dL Prot/Alb 6.5/4.0 g/dL AST/ALT 20/17 U/L BUN/Cr 15/0.8 g/dL Na/K/Cl 137/4.5/103mmol/L Ca/P 9.2/4.1 mg/dL T3 143 ng/dL (80~200) FT ng/dL (0.8~1.8) TSH 3.35 μU/mL (0.4~3.1)
10 Thyroid sonography
11 Thyroid sonography
12 Thyroid sonography
13 Pathology Papillary carcinoma Total thyroidectomy with ant. LND
이 0 임 (F/55) C.C : Rt. neck mass o/s ) 2 년전 P.I : 특이 병력 없던 환자로 2 년 전 종합검진에서 Rt. Neck mass 발견되어 추가 검사 권유 받았으나 그냥 지내던 중 further evaluation 위해 내원. PMHx : DM/HTN/TB/hepaitits (-/-/-/-), 가족력 (-) ROS : fever (-), weight loss (-), sweating (-) heat or cold intolerance (-), agitation (-) A/N/V/C/D (-/-/-/-/-) P/Ex : thyroid mass (+) size : 1x1cm location : Rt. Lobe margin : well defined bruit/thrill (-/-) consistency : hard tenderness : (-) movable(-) bruit/thrill (-/-) Case 3
15 CBD/DC 5520 /mm 3 – 14.0 g/dL – Hct 41%- PLT /mm 3 TB/DB 0.83/0.16 mg/dL Prot/Alb 7.0/3.9 g/dL AST/ALT 24/15 U/L BUN/Cr 10/0.8 g/dL Na/K/Cl 141/5.2/105mmol/L Ca/P 9.4/3.6 mg/dL FT ng/dL (0.8~1.8) TSH 3.22 μU/mL (0.4~3.1)
16 Thyroid sonography
17 Thyroid sonography
18 Thyroid sonography
19 Pathology Papillary carcinoma Total thyroidectomy with central LND
박 0 희 (F/60) C.C : Lt. thyroid mass o/s ) 1 달전 P.I : 20 년 전 당뇨 진단 받고 15 년 전부터 인슐린 사용 중이며 1 달전 정기 검사로 시행한 thyroid sono 에서 thyroid mass 발견 되어 내원. PMHx : DM/HTN/TB/Hepatitis (+/+/-/-), 가족력 (-) ROS : fever (-), weight loss (-), sweating (-) heat or cold intolerance (-), agitation (-) A/N/V/C/D (-/-/-/-/-) P/Ex : thyroid mass (+) size : 1x1cm location : Lt. Lobe (upper) margin : well defined consistency : hard tenderness : (-) movable(-) bruit/thrill (-/-) Case 4
21 CBD/DC 8440 /mm 3 – 13.1 g/dL – Hct 37.2%- PLT /mm 3 TB/DB 0.53/0.10 mg/dL Prot/Alb 6.7/4.1 g/dL AST/ALT 24/21 U/L BUN/Cr 9/1.0 g/dL Na/K/Cl 144/4.7/106mmol/L Ca/P 9.4/4.5 mg/dL T3 166 ng/dL (80~200) FT ng/dL (0.8~1.8) TSH 0.8 μU/mL (0.4~3.1) HbA1c 6.9%
22 Thyroid sonography
23 Thyroid sonography
24 Pathology Papillary carcinoma Total thyroidectomy with central LND