Ultrasound scanning in diagnosing primary thyroid lymphoma.

Xiaolei Xue, Liping Wu, Jinqing Zhang, Wei Sun, Shiqin Jiang, Xiaoling Chu, Yingzi Sun
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Abstract

Objective: This study aimed to summarize the clinical manifestations and ultrasound characteristics of primary thyroid lymphoma (PTL) and explore the key aspects in the process of diagnosing PTL.

Methods: We conducted a retrospective analysis of the clinical and ultrasound features of 11 patients with PTL who were admitted to Shandong Provincial Third Hospital, China, between May 2009 and August 2023. The pathology was confirmed in all cases through an ultrasound-guided core needle biopsy or surgical resection.

Results: The mean age of the 11 patients was 64.45±9.85 years. In six patients, the main clinical manifestation was a palpable mass in the neck, five of whom had a significant increase in the size of the mass within 3 months to 2 years. Eleven patients had coexisting Hashimoto's thyroiditis (HT). Three patients were diagnosed as having diffuse-type PTL, wherein the ultrasound showed enlargement of the affected thyroid gland with diffusely uneven hypoechoic parenchyma. In 7 patients with nodular type PTL and 1 case of mixed type PTL, the ultrasonographic features of the nodular lesions were of irregular morphology and yet had distinct borders, and only 1 case had gross calcification. There were 7 cases of hypoechoic lesions (7/11 cases, 63.6%), 9 cases where the lesions had linear echo chains (9/11 cases, 81.8%), and 10 cases (90.9%) where there was echogenic enhancement posterior to the lesion.

Conclusion: In elderly patients with HT, the thyroid volume increases significantly in a short period of time and symptoms associated with compression in the neck region appear. The ultrasound characteristics were extremely hypoechoic lesions in the thyroid parenchyma, with more linear echo chains visible inside, accompanied by posterior echo enhancement. When encountering such presentations, physicians must consider the possibility of PTL. Performing a core needle biopsy in cases that raise suspicion can reduce the incidence of misdiagnosis.

超声波扫描诊断原发性甲状腺淋巴瘤
目的本研究旨在总结原发性甲状腺淋巴瘤(PTL)的临床表现和超声特征,探讨诊断PTL过程中的关键环节:我们对2009年5月至2023年8月期间山东省立第三医院收治的11例PTL患者的临床和超声特征进行了回顾性分析。所有病例均通过超声引导下的核心针穿刺活检或手术切除确诊病理:结果:11 例患者的平均年龄为(64.45±9.85)岁。6例患者的主要临床表现为颈部可触及肿块,其中5例患者的肿块在3个月至2年内明显增大。11名患者同时患有桥本氏甲状腺炎(HT)。3名患者被诊断为弥漫型PTL,超声波显示受影响的甲状腺肿大,实质呈弥漫性不均匀低回声。在7例结节型PTL患者和1例混合型PTL患者中,结节性病变的超声特征是形态不规则,但边界清晰,只有1例患者有明显的钙化。低回声病变 7 例(7/11 例,63.6%),病变呈线状回声链 9 例(9/11 例,81.8%),病变后方回声增强 10 例(90.9%):结论:老年甲状腺肿大患者的甲状腺体积会在短期内明显增大,并出现颈部压迫症状。超声特征是甲状腺实质内出现极低回声病变,内部可见较多线状回声链,伴有后方回声增强。当遇到这种表现时,医生必须考虑到PTL的可能性。对可疑病例进行核心针活检可降低误诊率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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