Objective: 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. Methods: 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. Results: 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. Conclusion: PTL has certain sonographic features, with assistance of US-CNB, more accurate diagnosis of PTL can be obtained.
目的： 探讨原发性甲状腺淋巴瘤（primary thyroid lymphoma，PTL）的高频超声特征，以及超声引导下粗针穿刺活检（ultrasound-guided core needle biopsy，US-CNB）在诊断PTL中的应用价值。 方法： 回顾性分析浙江大学医学院附属邵逸夫医院2013年1月至2018年6月期间怀疑为PTL的24例患者的病例资料，其中施行了US-CNB的23例，未经US-CNB直接手术者1例。男性5例，女性19例，年龄39~75岁。对施行了US-CNB的23例患者进行穿刺安全性及有效性分析，并对最终病理确诊为PTL的20例患者的声像图特征进行要素化分析。采用描述性统计学方法进行研究。 结果： 接受US-CNB的23例可疑PTL患者中，组织学病理诊断为亚急性甲状腺炎1例，未分化癌1例，桥本甲状腺炎1例，纤维性甲状腺炎1例，诊断为PTL者18例，另1例US-CNB穿刺标本病理诊断困难（后经手术活检取材，最终病理诊断为PTL），US-CNB对PTL的穿刺诊断成功率为18/19，本组无任何病例发生严重穿刺并发症。另1例未行US-CNB直接手术经病理明确为PTL。20例PTL的声像图特征主要包括：结节大多形态欠规则，边缘欠光整；内部大多呈低回声或极低回声，蜂窝状或条索状改变；较少伴有钙化；病灶多发为主；大多可见较丰富的血流信号；多伴有后方回声增强；甲状腺体积多增大或形态不规则；若同时伴有侧颈部或中央区淋巴结肿大对诊断更有帮助。 结论： PTL具有一定的高频超声声像图特征，联合US-CNB可以对PTL作出较为准确的诊断。.