{"id":33183,"date":"2022-07-02T05:43:01","date_gmt":"2022-07-01T22:43:01","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=33183"},"modified":"2022-07-02T05:43:01","modified_gmt":"2022-07-01T22:43:01","slug":"ung-thu-tuyen-giap-the-nang","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/ung-thu-tuyen-giap-the-nang\/","title":{"rendered":"Ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 nang"},"content":{"rendered":"

T\u1ea3i file PDF b\u00e0i vi\u1ebft Ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 nang – Follicular thyroid cancer <\/b>t\u1ea1i \u0111\u00e2y<\/a><\/p>\n

B\u00e0i vi\u1ebft \u0111\u01b0\u1ee3c d\u1ecbch b\u1edfi Tr\u1ea7n Th\u1ecb Thu v\u00e0 Dr. L\u00ea V\u0169 Duy<\/p>\n

Ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 nang (Follicular thyroid carcinoma (FTC)) l\u00e0 t\u1ed5n th\u01b0\u01a1ng \u00e1c t\u00ednh ph\u1ed5 bi\u1ebfn th\u1ee9 hai c\u1ee7a tuy\u1ebfn gi\u00e1p sau ung th\u01b0 th\u1ec3 nh\u00fa v\u00e0 chi\u1ebfm kho\u1ea3ng 10-20% c\u00e1c kh\u1ed1i u tuy\u1ebfn gi\u00e1p.<\/strong><\/p>\n

D\u1ecbch t\u1ec5<\/h2>\n
\u0110i\u1ec3n h\u00ecnh x\u1ea3y ra \u1edf ph\u1ee5 n\u1eef, \u1edf nh\u00f3m tu\u1ed5i cao h\u01a1n so v\u1edbi K th\u1ec3 nh\u00fa (40-60 tu\u1ed5i).<\/p>\n
Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng<\/h2>\n
Kho\u1ea3ng 20% b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ec3u hi\u1ec7n di c\u0103n theo \u0111\u01b0\u1eddng m\u00e1u \u1edf th\u1eddi \u0111i\u1ec3m ch\u1ea9n \u0111o\u00e1n (kh\u00e1c v\u1edbi th\u1ec3 nh\u00fa ch\u1ec9 c\u00f3 5-10% c\u00f3 di c\u0103n h\u1ea1ch \u1edf th\u1eddi \u0111i\u1ec3m ch\u1ea9n \u0111o\u00e1n).<\/p>\n
GEN<\/h2>\n
Gen sinh ung th\u01b0 Ras d\u01b0\u01a1ng t\u00ednh \u1edf m\u1ed9t t\u1ef7 l\u1ec7 \u0111\u00e1ng k\u1ec3 c\u00e1c b\u1ec7nh nh\u00e2n.<\/p>\n
FNA<\/h2>\n
FNA kh\u00f4ng th\u1ec3 ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c gi\u1eefa u tuy\u1ebfn gi\u00e1p th\u1ec3 nang v\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn gi\u00e1p th\u1ec3 nang. Ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf l\u00e0 c\u1ea7n thi\u1ebft.<\/p>\n
\u0110\u1eb7c \u0111i\u1ec3m h\u00ecnh \u1ea3nh<\/h2>\n
Si\u00eau \u00e2m<\/h3>\n
T\u1ed5n th\u01b0\u01a1ng \u0111i\u1ec3n h\u00ecnh gi\u1ea3m \u00e2m. Th\u01b0\u1eddng kh\u00f4ng bi\u1ebfn \u0111\u1ed5i d\u1ea1ng nang.<\/p>\n
Y h\u1ecdc h\u1ea1t nh\u00e2n<\/h3>\n
\u0110i\u1ec3n h\u00ecnh t\u0103ng t\u1eadp trung Tc-99m-Pertechnetate, kh\u00f4ng h\u1ea5p th\u1ee5 Iod ph\u00f3ng x\u1ea1.<\/p>\n
\u0110i\u1ec1u tr\u1ecb v\u00e0 ti\u00ean l\u01b0\u1ee3ng<\/h2>\n
\u0110i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt t\u1ea1i ch\u1ed7 v\u00e0 Iod ph\u00f3ng x\u1ea1. Ti\u00ean l\u01b0\u1ee3ng k\u00e9m h\u01a1n K th\u1ec3 nh\u00fa nh\u01b0ng t\u1ed1t h\u01a1n th\u1ec3 k\u00e9m bi\u1ec7t h\u00f3a, v\u00e0 ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 bi\u1ec3u hi\u1ec7n v\u00e0 m\u1ee9c \u0111\u1ed9 di c\u0103n xa. V\u1edbi b\u1ec7nh giai \u0111o\u1ea1n c\u00f2n khu tr\u00fa, ti\u00ean l\u01b0\u1ee3ng s\u1ed1ng tr\u00ean 10 n\u0103m l\u00e0 90%, khi c\u00f3 di c\u0103n xa l\u00e0 ~ 50%.<\/p>\n
V\u00ed d\u1ee5<\/h2>\n
V\u00ed d\u1ee5 1<\/h3>\n
B\u1ec7nh nh\u00e2n n\u1eef, 80 tu\u1ed5i. C\u00f3 bi\u1ec3u hi\u1ec7n \u0111au l\u01b0ng.<\/p>\n
Tr\u00ean h\u00ecnh \u1ea3nh CT:<\/h4>\n
\n
T\u1ed5n th\u01b0\u01a1ng \u00e1c t\u00ednh th\u00e2n \u0111\u1ed1t s\u1ed1ng T8 g\u1ee3i \u00fd di c\u0103n.<\/li>\n
Nhi\u1ec1u h\u1ea1ch trung th\u1ea5t tr\u00ean b\u00ean ph\u1ea3i.<\/li>\n
Tr\u00e0n d\u1ecbch khoang m\u00e0ng ph\u1ed5i ph\u1ea3i, d\u00e0y m\u00e0ng ph\u1ed5i ph\u1ea3i lan t\u1ecfa nh\u01b0ng kh\u00f4ng c\u00f3 n\u1ed1t m\u00e0ng ph\u1ed5i.<\/li>\n
Nhi\u1ec1u n\u1ed1t tuy\u1ebfn gi\u00e1p.<\/li>\n<\/ul>\n
$\"\"$ <\/p>\n
PET\/CT:<\/h4>\n
T\u1ed5n th\u01b0\u01a1ng di c\u0103n x\u01b0\u01a1ng \u0111\u01a1n \u1ed5. C\u00f3 t\u0103ng h\u1ea5p th\u1ee5 FDG \u1edf th\u00f9y gi\u00e1p ph\u1ea3i v\u00e0 eo tuy\u1ebfn.<\/p>\n
$\"\"$ <\/p>\n
Si\u00eau \u00e2m:<\/h4>\n
Nhi\u1ec1u n\u1ed1t tuy\u1ebfn gi\u00e1p v\u1edbi n\u1ed1t nghi ng\u1edd \u1edf eo tuy\u1ebfn (c\u00f3 k\u00edch th\u01b0\u1edbc 2,9cm, ch\u1ee7 y\u1ebfu th\u00e0nh ph\u1ea7n \u0111\u1eb7c gi\u1ea3m \u00e2m, b\u1edd kh\u00f4ng \u0111\u1ec1u, c\u00f3 chi\u1ec1u cao l\u1edbn h\u01a1n chi\u1ec1u r\u1ed9ng \u2013 TIRADS 5). Nhi\u1ec1u n\u1ed1t gi\u1ea3m \u00e2m kh\u00e1c \u1edf th\u00f9y ph\u1ea3i tuy\u1ebfn gi\u00e1p v\u1edbi h\u1ed7n h\u1ee3p nang v\u00e0 \u0111\u1eb7c (TIRADS 3) .<\/p>\n
$\"\"$ <\/p>\n
V\u00ed d\u1ee5 2<\/h3>\n
B\u1ec7nh nh\u00e2n n\u1eef, l\u1edbn tu\u1ed5i c\u00f3 ti\u1ec1n s\u1eed ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 nang. Tr\u00ean h\u00ecnh \u1ea3nh l\u00e0 t\u1ed5n th\u01b0\u01a1ng di c\u0103n x\u01b0\u01a1ng s\u1ecd.<\/p>\n
$\"\"$ $\"\"$ <\/p>\n
Ngu\u1ed3n tham kh\u1ea3o<\/h2>\n
\n
Dr Daniel J Bell, Follicular thyroid cancer<\/a>, Radiopaedia. Truy c\u1eadp ng\u00e0y 1\/7\/2022<\/li>\n
Dr Bruno Di Muzio, Follicular thyroid carcinoma – spinal metastasis<\/a>, Radiopaedia. Truy c\u1eadp ng\u00e0y 1\/7\/2022<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"
T\u1ea3i file PDF b\u00e0i vi\u1ebft Ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 nang – Follicular thyroid cancer t\u1ea1i \u0111\u00e2y B\u00e0i vi\u1ebft \u0111\u01b0\u1ee3c d\u1ecbch b\u1edfi Tr\u1ea7n Th\u1ecb Thu v\u00e0 Dr. L\u00ea V\u0169 Duy Ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 nang (Follicular thyroid carcinoma (FTC)) l\u00e0 t\u1ed5n th\u01b0\u01a1ng \u00e1c t\u00ednh ph\u1ed5 bi\u1ebfn th\u1ee9 hai c\u1ee7a tuy\u1ebfn gi\u00e1p sau ung th\u01b0 […]\n","protected":false},"author":1,"featured_media":33190,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-33183","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/33183","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=33183"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/33183\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/33190"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=33183"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=33183"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=33183"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

GEN<\/h2>\nGen sinh ung th\u01b0 Ras d\u01b0\u01a1ng t\u00ednh \u1edf m\u1ed9t t\u1ef7 l\u1ec7 \u0111\u00e1ng k\u1ec3 c\u00e1c b\u1ec7nh nh\u00e2n.<\/p>\n

FNA<\/h2>\nFNA kh\u00f4ng th\u1ec3 ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c gi\u1eefa u tuy\u1ebfn gi\u00e1p th\u1ec3 nang v\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn gi\u00e1p th\u1ec3 nang. Ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf l\u00e0 c\u1ea7n thi\u1ebft.<\/p>\n

\u0110\u1eb7c \u0111i\u1ec3m h\u00ecnh \u1ea3nh<\/h2>\n

Si\u00eau \u00e2m<\/h3>\nT\u1ed5n th\u01b0\u01a1ng \u0111i\u1ec3n h\u00ecnh gi\u1ea3m \u00e2m. Th\u01b0\u1eddng kh\u00f4ng bi\u1ebfn \u0111\u1ed5i d\u1ea1ng nang.<\/p>\n

Y h\u1ecdc h\u1ea1t nh\u00e2n<\/h3>\n\u0110i\u1ec3n h\u00ecnh t\u0103ng t\u1eadp trung Tc-99m-Pertechnetate, kh\u00f4ng h\u1ea5p th\u1ee5 Iod ph\u00f3ng x\u1ea1.<\/p>\n

V\u00ed d\u1ee5<\/h2>\n

V\u00ed d\u1ee5 1<\/h3>\nB\u1ec7nh nh\u00e2n n\u1eef, 80 tu\u1ed5i. C\u00f3 bi\u1ec3u hi\u1ec7n \u0111au l\u01b0ng.<\/p>\n

PET\/CT:<\/h4>\nT\u1ed5n th\u01b0\u01a1ng di c\u0103n x\u01b0\u01a1ng \u0111\u01a1n \u1ed5. C\u00f3 t\u0103ng h\u1ea5p th\u1ee5 FDG \u1edf th\u00f9y gi\u00e1p ph\u1ea3i v\u00e0 eo tuy\u1ebfn.<\/p>\n<\/p>\n

V\u00ed d\u1ee5 2<\/h3>\nB\u1ec7nh nh\u00e2n n\u1eef, l\u1edbn tu\u1ed5i c\u00f3 ti\u1ec1n s\u1eed ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 nang. Tr\u00ean h\u00ecnh \u1ea3nh l\u00e0 t\u1ed5n th\u01b0\u01a1ng di c\u0103n x\u01b0\u01a1ng s\u1ecd.<\/p>\n <\/p>\n

GEN<\/h2>\n
Gen sinh ung th\u01b0 Ras d\u01b0\u01a1ng t\u00ednh \u1edf m\u1ed9t t\u1ef7 l\u1ec7 \u0111\u00e1ng k\u1ec3 c\u00e1c b\u1ec7nh nh\u00e2n.<\/p>\n

FNA<\/h2>\n
FNA kh\u00f4ng th\u1ec3 ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c gi\u1eefa u tuy\u1ebfn gi\u00e1p th\u1ec3 nang v\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn gi\u00e1p th\u1ec3 nang. Ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf l\u00e0 c\u1ea7n thi\u1ebft.<\/p>\n

Si\u00eau \u00e2m<\/h3>\n
T\u1ed5n th\u01b0\u01a1ng \u0111i\u1ec3n h\u00ecnh gi\u1ea3m \u00e2m. Th\u01b0\u1eddng kh\u00f4ng bi\u1ebfn \u0111\u1ed5i d\u1ea1ng nang.<\/p>\n

Y h\u1ecdc h\u1ea1t nh\u00e2n<\/h3>\n
\u0110i\u1ec3n h\u00ecnh t\u0103ng t\u1eadp trung Tc-99m-Pertechnetate, kh\u00f4ng h\u1ea5p th\u1ee5 Iod ph\u00f3ng x\u1ea1.<\/p>\n

V\u00ed d\u1ee5 1<\/h3>\n
B\u1ec7nh nh\u00e2n n\u1eef, 80 tu\u1ed5i. C\u00f3 bi\u1ec3u hi\u1ec7n \u0111au l\u01b0ng.<\/p>\n

PET\/CT:<\/h4>\n
T\u1ed5n th\u01b0\u01a1ng di c\u0103n x\u01b0\u01a1ng \u0111\u01a1n \u1ed5. C\u00f3 t\u0103ng h\u1ea5p th\u1ee5 FDG \u1edf th\u00f9y gi\u00e1p ph\u1ea3i v\u00e0 eo tuy\u1ebfn.<\/p>\n
$\"\"$ <\/p>\n

V\u00ed d\u1ee5 2<\/h3>\n
B\u1ec7nh nh\u00e2n n\u1eef, l\u1edbn tu\u1ed5i c\u00f3 ti\u1ec1n s\u1eed ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 nang. Tr\u00ean h\u00ecnh \u1ea3nh l\u00e0 t\u1ed5n th\u01b0\u01a1ng di c\u0103n x\u01b0\u01a1ng s\u1ecd.<\/p>\n
$\"\"$ $\"\"$ <\/p>\n