Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, China.
Department of General Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, China.
PLoS One. 2014 Dec 4;9(12):e114080. doi: 10.1371/journal.pone.0114080. eCollection 2014.
Primary thyroid lymphoma (PTL) is an uncommon thyroid malignancy. Despite the rarity of PTL, it is important to recognize PTL promptly because its management differs from that of all the other thyroid neoplasms. This study was designed to investigate the sonographic features of PTL.
Twenty-seven pathologically confirmed PTLs were categorized into diffuse and non-diffuse type. Sonographic features including thyroid size, thyroid background echotexture, lesion size, echogenecity, calcification, vascularity, cervical lymphadenopathy of each type were retrospectively analyzed.
All 27 PTLs were diffuse large B-cell lymphomas and were accompanied by diffuse Hashimoto's thyroiditis. Ten were diffuse type and seventeen were non-diffuse type sonographically. The observations in diffuse group included goiter (10/10, 100.0%), marked echogenesity (10/10, 100.0%), heterogeneous echotexture (10/10, 100.0%), and cervical lymphadenopathy (4/10, 40.0%). The observations in non-diffuse group included marked hypoechogenicity (17/17, 100.0%), heterogeneous background thyroid gland (17/17, 100.0%), goiter (15/17, 88.2%), increased vascularity (8/13, 61.5%), mulifocality (10/17, 58.8%), and cervical lymphadenopathy (7/17, 41.2%).
Although some common features were found, the sonographic appearance of PTL is unspecific, especially for the diffuse type. Therefore, interventional diagnostic procedures should be warranted in the clinical settings when PTL is suspected.
原发性甲状腺淋巴瘤（PTL）是一种罕见的甲状腺恶性肿瘤。尽管 PTL 较为罕见，但及时识别 PTL 非常重要，因为其治疗方法与所有其他甲状腺肿瘤不同。本研究旨在探讨 PTL 的超声特征。
回顾性分析 27 例经病理证实的 PTL 患者，分为弥漫型和非弥漫型。分析各型甲状腺大小、甲状腺背景回声、病灶大小、回声强度、钙化、血流、颈部淋巴结情况。
27 例 PTL 均为弥漫性大 B 细胞淋巴瘤，均伴有弥漫性桥本甲状腺炎。10 例为弥漫型，17 例为非弥漫型。弥漫型组观察到甲状腺肿大（10/10，100.0%）、显著高回声（10/10，100.0%）、不均匀回声（10/10，100.0%）和颈部淋巴结肿大（4/10，40.0%）。非弥漫型组观察到显著低回声（17/17，100.0%）、不均匀背景甲状腺（17/17，100.0%）、甲状腺肿大（15/17，88.2%）、血流增加（8/13，61.5%）、多发病灶（10/17，58.8%）和颈部淋巴结肿大（7/17，41.2%）。
尽管发现了一些共同特征，但 PTL 的超声表现并不特异，尤其是弥漫型。因此，当怀疑 PTL 时，应在临床环境中进行介入诊断程序。
