1. K GIÁP VỊ TRÍ KHÔNG THƯỜNG GẶP
BS VÕ THỊ PHƯƠNG TRINH
TT Y KHOA MEDIC

2. TỔNG QUAN TRƯỜNG HỢP LÂM SÀNG CÁC BẤT THƯỜNG VỀ GIẢI PHẪU TUYẾN GIÁP
TUYẾN GIÁP LẠC CHỖ
TÀI LIỆU THAM KHẢO
BÀI HỌC KINH NGHIỆM

3. CASE LÂM SÀNG CASE 2 : ID:170623063, 37F ĐC : Q10, TP HCM
KHÁM: CỤC VÙNG CỔ 3 NĂM

4. SIÊU ÂM

5. KHẢ NĂNG LÀ : NHÂN DƯỚI DA VÙNG CỔ NGHĨ NHÂN THÙY THÁP TUYẾN GIÁP (TIRADS 4) 2. NHÂN CỦA MÔ GIÁP LẠC CHỖ (TIRADS 4) 3. U ỐNG GIÁP LƯỠI ĐỀ NGHỊ: FNAC

9. KẾT QUẢ SIÊU ÂM

10. KẾT QUẢ SIÊU ÂM

11. CASE 2
ID : , 37F
LÍ DO KHÁM : KIỂM TRA
SIÊU ÂM:

14. KẾT QUẢ SIÊU ÂM

17. Pre-operative detection of thyroid pyramidal lobes by ultrasound and computed tomography.
Ryu JH1, Kim DW2, Kang T3.Author information
Abstract
This study aimed to assess the diagnostic accuracy of pre-operative ultrasound (US) and computed tomography (CT) for detecting thyroid pyramidal lobe (TPL). The prevalence of TPLs as diagnosed by thyroid US, neck CT and surgery was 58.5% (79/135), 56.3% (76/135) and 60% (81/135), respectively. We compared US and CT detection of TPLs with surgical data to determine their sensitivity (85.2% and 91.4%), specificity (81.5% and 94.4%), positive (87.3% and 96.1%) and negative (78.6% and 87.9%) predictive values and accuracy (83.7% and 92.6%). For detecting TPLs, both neck CT and thyroid US have good diagnostic value, although neck CT is more accurate than thyroid US.

18. Pre-operative detection of thyroid pyramidal lobes by ultrasound and computed tomography.
Ryu JH1, Kim DW2, Kang T3.Author information
Abstract
This study aimed to assess the diagnostic accuracy of pre-operative ultrasound (US) and computed tomography (CT) for detecting thyroid pyramidal lobe (TPL). The prevalence of TPLs as diagnosed by thyroid US, neck CT and surgery was 58.5% (79/135), 56.3% (76/135) and 60% (81/135), respectively. We compared US and CT detection of TPLs with surgical data to determine their sensitivity (85.2% and 91.4%), specificity (81.5% and 94.4%), positive (87.3% and 96.1%) and negative (78.6% and 87.9%) predictive values and accuracy (83.7% and 92.6%). For detecting TPLs, both neck CT and thyroid US have good diagnostic value, although neck CT is more accurate than thyroid US.

19. Pre-operative detection of thyroid pyramidal lobes by ultrasound and computed tomography.
Ryu JH1, Kim DW2, Kang T3.Author information
Abstract
This study aimed to assess the diagnostic accuracy of pre-operative ultrasound (US) and computed tomography (CT) for detecting thyroid pyramidal lobe (TPL). The prevalence of TPLs as diagnosed by thyroid US, neck CT and surgery was 58.5% (79/135), 56.3% (76/135) and 60% (81/135), respectively. We compared US and CT detection of TPLs with surgical data to determine their sensitivity (85.2% and 91.4%), specificity (81.5% and 94.4%), positive (87.3% and 96.1%) and negative (78.6% and 87.9%) predictive values and accuracy (83.7% and 92.6%). For detecting TPLs, both neck CT and thyroid US have good diagnostic value, although neck CT is more accurate than thyroid US.

20. Pre-operative detection of thyroid pyramidal lobes by ultrasound and computed tomography.
Ryu JH1, Kim DW2, Kang T3.Author information
Abstract
This study aimed to assess the diagnostic accuracy of pre-operative ultrasound (US) and computed tomography (CT) for detecting thyroid pyramidal lobe (TPL). The prevalence of TPLs as diagnosed by thyroid US, neck CT and surgery was 58.5% (79/135), 56.3% (76/135) and 60% (81/135), respectively. We compared US and CT detection of TPLs with surgical data to determine their sensitivity (85.2% and 91.4%), specificity (81.5% and 94.4%), positive (87.3% and 96.1%) and negative (78.6% and 87.9%) predictive values and accuracy (83.7% and 92.6%). For detecting TPLs, both neck CT and thyroid US have good diagnostic value, although neck CT is more accurate than thyroid US.

21. Pre-operative detection of thyroid pyramidal lobes by ultrasound and computed tomography.
Ryu JH1, Kim DW2, Kang T3.Author information
Abstract
This study aimed to assess the diagnostic accuracy of pre-operative ultrasound (US) and computed tomography (CT) for detecting thyroid pyramidal lobe (TPL). The prevalence of TPLs as diagnosed by thyroid US, neck CT and surgery was 58.5% (79/135), 56.3% (76/135) and 60% (81/135), respectively. We compared US and CT detection of TPLs with surgical data to determine their sensitivity (85.2% and 91.4%), specificity (81.5% and 94.4%), positive (87.3% and 96.1%) and negative (78.6% and 87.9%) predictive values and accuracy (83.7% and 92.6%). For detecting TPLs, both neck CT and thyroid US have good diagnostic value, although neck CT is more accurate than thyroid US.

22. stract
This study aimed to assess the diagnostic accuracy of pre-operative ultrasound (US) and computed tomography (CT) for detecting thyroid pyramidal lobe (TPL). The prevalence of TPLs as diagnosed by thyroid US, neck CT and surgery was 58.5% (79/135), 56.3% (76/135) and 60% (81/135), respectively. We compared US and CT detection of TPLs with surgical data to determine their sensitivity (85.2% and 91.4%), specificity (81.5% and 94.4%), positive (87.3% and 96.1%) and negative (78.6% and 87.9%) predictive values and accuracy (83.7% and 92.6%). For detecting TPLs, both neck CT and thyroid US have good diagnostic value, although neck CT is more accurate than thyroid US.

23. Pre-operative detection of thyroid pyramidal lobes by ultrasound and computed tomography.
Ryu JH1, Kim DW2, Kang T3.Author information
Abstract
This study aimed to assess the diagnostic accuracy of pre-operative ultrasound (US) and computed tomography (CT) for detecting thyroid pyramidal lobe (TPL). The prevalence of TPLs as diagnosed by thyroid US, neck CT and surgery was 58.5% (79/135), 56.3% (76/135) and 60% (81/135), respectively. We compared US and CT detection of TPLs with surgical data to determine their sensitivity (85.2% and 91.4%), specificity (81.5% and 94.4%), positive (87.3% and 96.1%) and negative (78.6% and 87.9%) predictive values and accuracy (83.7% and 92.6%). For detecting TPLs, both neck CT and thyroid US have good diagnostic value, although neck CT is more accurate than thyroid US.

24. Pre-operative detection of thyroid pyramidal lobes by ultrasound and computed tomography.
Ryu JH1, Kim DW2, Kang T3.Author information
Abstract
This study aimed to assess the diagnostic accuracy of pre-operative ultrasound (US) and computed tomography (CT) for detecting thyroid pyramidal lobe (TPL). The prevalence of TPLs as diagnosed by thyroid US, neck CT and surgery was 58.5% (79/135), 56.3% (76/135) and 60% (81/135), respectively. We compared US and CT detection of TPLs with surgical data to determine their sensitivity (85.2% and 91.4%), specificity (81.5% and 94.4%), positive (87.3% and 96.1%) and negative (78.6% and 87.9%) predictive values and accuracy (83.7% and 92.6%). For detecting TPLs, both neck CT and thyroid US have good diagnostic value, although neck CT is more accurate than thyroid US.

25. Pre-operative detection of thyroid pyramidal lobes by ultrasound and computed tomography.
Ryu JH1, Kim DW2, Kang T3.Author information
Abstract
This study aimed to assess the diagnostic accuracy of pre-operative ultrasound (US) and computed tomography (CT) for detecting thyroid pyramidal lobe (TPL). The prevalence of TPLs as diagnosed by thyroid US, neck CT and surgery was 58.5% (79/135), 56.3% (76/135) and 60% (81/135), respectively. We compared US and CT detection of TPLs with surgical data to determine their sensitivity (85.2% and 91.4%), specificity (81.5% and 94.4%), positive (87.3% and 96.1%) and negative (78.6% and 87.9%) predictive values and accuracy (83.7% and 92.6%). For detecting TPLs, both neck CT and thyroid US have good diagnostic value, although neck CT is more accurate than thyroid US.

26. Pre-operative detection of thyroid pyramidal lobes by ultrasound and computed tomography.
Ryu JH1, Kim DW2, Kang T3.Author information
Abstract
This study aimed to assess the diagnostic accuracy of pre-operative ultrasound (US) and computed tomography (CT) for detecting thyroid pyramidal lobe (TPL). The prevalence of TPLs as diagnosed by thyroid US, neck CT and surgery was 58.5% (79/135), 56.3% (76/135) and 60% (81/135), respectively. We compared US and CT detection of TPLs with surgical data to determine their sensitivity (85.2% and 91.4%), specificity (81.5% and 94.4%), positive (87.3% and 96.1%) and negative (78.6% and 87.9%) predictive values and accuracy (83.7% and 92.6%). For detecting TPLs, both neck CT and thyroid US have good diagnostic value, although neck CT is more accurate than thyroid US.

27. Pre-operative detection of thyroid pyramidal lobes by ultrasound and computed tomography.
Ryu JH1, Kim DW2, Kang T3.Author information
Abstract
This study aimed to assess the diagnostic accuracy of pre-operative ultrasound (US) and computed tomography (CT) for detecting thyroid pyramidal lobe (TPL). The prevalence of TPLs as diagnosed by thyroid US, neck CT and surgery was 58.5% (79/135), 56.3% (76/135) and 60% (81/135), respectively. We compared US and CT detection of TPLs with surgical data to determine their sensitivity (85.2% and 91.4%), specificity (81.5% and 94.4%), positive (87.3% and 96.1%) and negative (78.6% and 87.9%) predictive values and accuracy (83.7% and 92.6%). For detecting TPLs, both neck CT and thyroid US have good diagnostic value, although neck CT is more accurate than thyroid US.

28. Pre-operative detection of thyroid pyramidal lobes by ultrasound and computed tomography.
Ryu JH1, Kim DW2, Kang T3.Author information
Abstract
This study aimed to assess the diagnostic accuracy of pre-operative ultrasound (US) and computed tomography (CT) for detecting thyroid pyramidal lobe (TPL). The prevalence of TPLs as diagnosed by thyroid US, neck CT and surgery was 58.5% (79/135), 56.3% (76/135) and 60% (81/135), respectively. We compared US and CT detection of TPLs with surgical data to determine their sensitivity (85.2% and 91.4%), specificity (81.5% and 94.4%), positive (87.3% and 96.1%) and negative (78.6% and 87.9%) predictive values and accuracy (83.7% and 92.6%). For detecting TPLs, both neck CT and thyroid US have good diagnostic value, although neck CT is more accurate than thyroid US.

29. Pre-operative detection of thyroid pyramidal lobes by ultrasound and computed tomography.
Ryu JH1, Kim DW2, Kang T3.Author information
Abstract
This study aimed to assess the diagnostic accuracy of pre-operative ultrasound (US) and computed tomography (CT) for detecting thyroid pyramidal lobe (TPL). The prevalence of TPLs as diagnosed by thyroid US, neck CT and surgery was 58.5% (79/135), 56.3% (76/135) and 60% (81/135), respectively. We compared US and CT detection of TPLs with surgical data to determine their sensitivity (85.2% and 91.4%), specificity (81.5% and 94.4%), positive (87.3% and 96.1%) and negative (78.6% and 87.9%) predictive values and accuracy (83.7% and 92.6%). For detecting TPLs, both neck CT and thyroid US have good diagnostic value, although neck CT is more accurate than thyroid US.

30. BÀI HỌC KINH NGHIỆM
CÓ NHIỀU BẤT THƯỜNG VỀ GIẢI PHẪU TUYẾN GIÁP , KHI SIÊU ÂM DỄ BỎ SÓT THÙY THÁP -> LƯU Ý KHI PHẪU THUẬT
2. NẾU NÓI SIÊU ÂM TẦM SOÁT K GIÁP THÌ CHƯA ĐỦ VÌ MÔ GIÁP CÓ THỂ LẠC CHỖ NHIỀU VỊ TRÍ
3. DỄ NHẦM NANG GIÁP LƯỠI VÀ BN SẼ BỊ BỎ QUA CHẨN ĐOÁN K GIÁP.
4. UNG THƯ VỊ TRÍ THÙY THÁP DỄ XÂM LẤN XUNG QUANH CẦN ĐƯỢC CĐ ĐÚNG

31. TÀI LIỆU THAM KHẢO
1. Bệnh học ung bướu cơ bản
2. Milojevic B, Tosevski J, Milisavljevic M, Babic D, Malikovic A. Pyramidal lobe of the human thyroid gland: an anatomical study with clinical implications. Rom J Morphol Embryol. 2013;54:285–289.[PubMed] [Google Scholar
3. Clinical characteristics of papillary thyroid carcinoma arising from the pyramidal lobe. .[PubMed] [Google Scholar.

32. Xin cảm ơn.