Xu L L, Li S Y, Zhu J, Lyu J G, Zhang M X, Gao L, Xie L, Jiang Z N, Fu G X
Department of Ultrasound, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou 310016, China.
Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou 310016, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Aug 7;56(8):858-862. doi: 10.3760/cma.j.cn115330-20201201-00901.
To investigate the sonographic features of primary thyroid lymphoma (PTL) and to evaluate the clinical significance of ultrasound-guided core needle biopsy (US-CNB) in PTL. A total of 24 patients with suspected PTL in Sir Run Run Shaw Hospital from January 2013 to June 2018 were analyzed retrospectively. All cases were confirmed by pathology, of them 23 patients received US-CNB and 1 patient chose operation without US-CNB, including 5 males and 19 females, aged from 39 to 75 years old. The effectiveness and safety of 23 patients with US-CNB were evaluated, and the sonographic features of 20 patients with PTL diagnosed by pathology were analyzed. Descriptive statistical methods were used in the study. In the 23 patients with suspected PTL underwent US-CNB, 18 patients were diagnosed as PTL, 4 patients were respectively diagnosed as subacute thyroiditis, anaplastic carcinoma, Hashimoto's thyroiditis, and fibro thyroiditis, and the another patient was hard to diagnose by US-CNB and then was diagnosed as PTL by surgical biopsy. The success rate of US-CNB for diagnosis of PTL was 18/19, and no severe complications occurred in the patients with US-CNB. The other case was diagnosed as PTL by surgical biopsy without US-CNB. Sonographic features of 20 cases with PTL (18 cases diagnosed by US-CNB and 2 cases by surgery or surgery biopsy) were as follows: (1) Most nodules had irregular shapes and unsmooth margins; (2) Hypoechoic or markedly hypoechoic nodules with honeycombed or cord structures were observed in most cases; (3) Calcification was rare; (4) Multiple lesions were common; (5) Abundant intralesional vascularization was commonly observed; (6) Most cases had intensification of posterior acoustic enhancement; (7) Thyroid gland enlargement or with irregular shape; and (8) PTL often accompanied with lymph nodes enlargement in lateral neck or central region. PTL has certain sonographic features, with assistance of US-CNB, more accurate diagnosis of PTL can be obtained.
探讨原发性甲状腺淋巴瘤（PTL）的超声特征，评估超声引导下粗针穿刺活检（US-CNB）在PTL中的临床意义。回顾性分析2013年1月至2018年6月在浙江大学医学院附属邵逸夫医院疑似PTL的24例患者。所有病例均经病理确诊，其中23例患者接受了US-CNB，1例患者未行US-CNB而选择手术，包括5例男性和19例女性，年龄39至75岁。评估23例行US-CNB患者的有效性和安全性，分析20例经病理确诊为PTL患者的超声特征。本研究采用描述性统计方法。在23例疑似PTL并接受US-CNB的患者中，18例被诊断为PTL，4例分别被诊断为亚急性甲状腺炎、未分化癌、桥本甲状腺炎和纤维性甲状腺炎，另1例经US-CNB难以诊断，后经手术活检诊断为PTL。US-CNB诊断PTL的成功率为18/19，行US-CNB的患者未发生严重并发症。另一例未行US-CNB经手术活检诊断为PTL。20例PTL患者（18例经US-CNB诊断，2例经手术或手术活检诊断）的超声特征如下：（1）多数结节形态不规则，边界不光滑；（2）多数病例可见低回声或明显低回声结节，呈蜂窝状或条索状结构；（3）钙化少见；（4）多发病灶常见；（5）病灶内血管丰富常见；（6）多数病例后方回声增强；（7）甲状腺肿大或形态不规则；（8）PTL常伴有侧颈部或中央区淋巴结肿大。PTL具有一定的超声特征，借助US-CNB可更准确地诊断PTL。
