Department of Ultrasound, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), No.1 East Banshan 7 Road, Gongshu District, Hangzhou, 310022, China.
Institute of Basic Medicine and Cancer (IBMC), Chinese Academy Of Sciences, Hangzhou, 310022, China.
BMC Cancer. 2022 Aug 31;22(1):938. doi: 10.1186/s12885-022-10035-2.
Primary thyroid lymphoma (PTL) and papillary thyroid carcinoma (PTC) are both thyroid malignancies, but their therapeutic methods and prognosis are different. This study aims to explore their sonographic and computed tomography(CT)features, and to improve the early diagnosis rate.
The clinical and imaging data of 50 patients with non-diffuse PTL and 100 patients with PTC confirmed by pathology were retrospectively analysed.
Of the 150 patients, from the perspective of clinical data, between non-diffuse PTL and PTC patients existed significant difference in age, maximum diameter of nodule, asymmetric enlargement and Hashimoto's thyroiditis (P < 0.001), but not in gender ratio, echo texture, cystic change and anteroposterior-to-transverse ratio (P > 0.05). With respect to sonographic feature, non-diffuse PTL patients had a higher proportion than PTC patients in markedly hypoechoic, internal linear echogenic strands, posterior echo enhancement, rich vascularity, lack of calcification and homogeneous enhancement, with statistically significant difference (P < 0.05), while PTC patients had a higher proportion than non-diffuse PTL patients in irregular border, circumscribed margin, capsular invasion and significant enhancement, with statistically significant difference (P < 0.001). With respect to CT feature, non-diffuse PTL patients were significantly different from PTC patients in the non-contrast CT value mean, venous phase CT value mean, enhanced intensity and homogeneity of nodules (P < 0.05). Multivariate logistic regression analysis showed that age (OR = 1.226, 95%CI:1.056 ~ 1.423, P = 0.007), posterior echo enhancement (OR = 51.152, 95%CI: 2.934 ~ 891.738, P = 0.007), lack of calcification (OR = 0.013, 95%CI: 0.000 ~ 0.400, P = 0.013) and homogeneous enhancement (OR = 0.020, 95%CI: 0.001 ~ 0.507, P = 0.018) were independent risk factors.
Sonographic and CT features of the presence of posterior echo enhancement, lack of calcification and homogeneous enhancement were valuable to distinguishing non-diffuse PTL from PTC.
原发性甲状腺淋巴瘤（PTL）和甲状腺乳头状癌（PTC）都是甲状腺恶性肿瘤，但它们的治疗方法和预后不同。本研究旨在探讨它们的超声和计算机断层扫描（CT）特征，以提高早期诊断率。
回顾性分析经病理证实的 50 例非弥漫性 PTL 患者和 100 例 PTC 患者的临床和影像学资料。
在 150 例患者中，从临床数据来看，非弥漫性 PTL 患者与 PTC 患者在年龄、结节最大直径、不对称增大和桥本甲状腺炎方面存在显著差异（P<0.001），但在性别比例、回声纹理、囊性变和前后径与横径比方面无差异（P>0.05）。在超声特征方面，非弥漫性 PTL 患者的明显低回声、内部线性回声条纹、后回声增强、丰富的血管、无钙化和均匀增强的比例高于 PTC 患者，差异有统计学意义（P<0.05），而 PTC 患者的不规则边界、边界清晰、包膜侵犯和明显增强的比例高于非弥漫性 PTL 患者，差异有统计学意义（P<0.001）。在 CT 特征方面，非弥漫性 PTL 患者与 PTC 患者在平扫 CT 值均值、静脉期 CT 值均值、结节增强强度和均匀性方面存在显著差异（P<0.05）。多因素 logistic 回归分析显示，年龄（OR=1.226，95%CI：1.0561.423，P=0.007）、后回声增强（OR=51.152，95%CI：2.934891.738，P=0.007）、无钙化（OR=0.013，95%CI：0.0000.400，P=0.013）和均匀增强（OR=0.020，95%CI：0.0010.507，P=0.018）是独立的危险因素。
存在后回声增强、无钙化和均匀增强的超声和 CT 特征有助于鉴别非弥漫性 PTL 和 PTC。
