摘要
目的探讨原发性甲状腺淋巴瘤（primary thyroid lymphoma，PTL）的超声特征及超声引导甲状腺活检的诊断价值。方法回顾性分析2003年至2013年北京协和医院22例经病理证实的P．rL患者的临床资料（年龄32—81岁，中位年龄61岁’）、超声声像图表现及活检方式，将PTL超声表现分为3型，即弥漫型、结节型和混合型。结果22例门L患者的主要病理类型为黏膜相关淋巴组织B细胞淋巴瘤（45．5％，10／22）和弥漫性大B细胞淋巴瘤（36．4％，8／22）。16例PTL患者（72．？％）首发症状为颈部肿物近期明显增大。22例PTL患者中16例（72．7％）超声诊断为恶性或可疑恶性，6例（27．3％）超声诊断为良性。10例行超声引导细针抽吸活检，其中仅2例诊断可疑PTL；9例行超声引导组织活检，其中8例获得明确病理诊断。15例PTL患者接受外科手术活检，获得病理诊断。PTL超声声像图特征分为弥漫型（45．5％，10／22）、结节型（40．9％，9／22）和混合型（13．6％，3／22）。结论超声声像图特征有助于P，rL诊断，尤其是对有近期颈部肿物迅速增大病史的患者。超声引导组织活检安全、准确，是诊断胛L的首选方法。
Objective To explore the sonographic findings of primary thyroid lymphoma （IYFL） and eval- uate the role of ultrasound-guided core-needle biopsy in diagnosing this disease. Methods The clinical data, sonographic, and biopsy modes of 22 patients （ age range, 32 - 81 years ; median, 61 years） with pathologically confirmed IYI＇L were retrospectively analyzed. The sonographic findings of PTL were divided into three＇types ： dif- fuse type, nodular type, and mixed type. Results The main pathologic types of PLT in these 22 patients includ- ed mucosa-associated lymphoid tissue lymphoma （ n = 10, 45.5% ） and diffuse large B-cell lymphoma （ n -~ 8, 36. 4% ）. In 16 patients （72.7%）, the initial symptom was enlarged neck mass. Among the 22 patients with a diagnosis of PTL, 16 （72.7%） were sonographically diagnosed as malignancies or suspected malignancies and 6 （27.3%） as benign lesions. In 10 patients who had received ultrasound-guided fine-needle aspiration biopsy, only 2 were diagnosed as suspected malignancies. In 9 patients who had received ultrasound-guided core-needle biopsy, 8 （88.9%） achieved definitive pathological diagnoses. In 15 patients who had undergone surgical biop- sy, pathological diagnoses were obtained in all of them. The distribution of the sonographie findings of PTL was as follows： diffuse type, n = 10 （45.5%） ; nodular type, n = 9 （40. 9% ） ; and mixed types, n = 3 （ 13.6% ）. Conclusions Ultrasonography is helpful for PTL diagnosis, especially in patients with rapid thyroid enlargement. Ultrasound-guided core-needle biopsy is safe and accurate, and therefore remains a preferred method for diagnosing thyroid lymphoma.
出处
《协和医学杂志》
2014年第1期3-7,共5页
Medical Journal of Peking Union Medical College Hospital
基金
国家高技术研究发展计划(863计划)(2006AA02Z4B3)
关键词
淋巴瘤
甲状腺肿瘤
甲状腺活检
超声引导
lymphoma
thyroid neoplasm
thyroid biopsy
ultrasound guidance
