摘要
目的分析原发性甲状腺淋巴瘤（PTL）的超声声像图特点及临床病理特征。方法回顾性分析21例病理证实的PTL患者的声像图表现及其临床病理特征。结果21例PTL中，15例为弥漫大B细胞淋巴瘤，4例为黏膜相关淋巴组织结外边缘区B细胞淋巴瘤，1例小B细胞淋巴瘤，1例经典型霍奇金淋巴瘤。其中8例病理证实合并桥本甲状腺炎；超声显示双侧或单侧不对称性甲状腺弥漫性肿大（21／21，100％），呈不均匀低回声或极低回声（21／21，100％），内部可夹杂线状或粗细不等“索条状”及“网格状”中高回声及“云团状”高回声，病灶后方回声增强（19／21，90．5％）。局灶性病变呈结节状低回声（2／21，9．5％），形态规则或不规则；PTL病灶血流增加（13／21，61．9％）；12例（57．1％）侵犯颈部淋巴结，2例（9．5％）累及颈前肌，1例（4．8％）压迫气管。临床13例PTL短期颈部肿块快速增大，另有气管、食管及喉返神经等压迫症状，仅3例无不适症状。结论PTL具有共同的声像图特点，应结合临床并行超声引导下穿刺活检，必要时手术，可减少误诊。
Objective To analyze the uhrasonographic and clinicopathological features of primary thyroid lymphoma（PTL）. Methods The ultrasonographic and clinieopathological featuresof 21 cases of pathologically-confirmed PTLs were analyzed retrospectively. Results Of all 21 PTLs, 15 cases were diffuse large B-cell lymphoma, 4 were mucosal-assoeiated lymphoid tissue extranodular marginal zone B-cell lymphoma, 1 was small B-cell lymphoma and 1 was classical Hodgkin lymphoma. Eight cases were proved by pathology with concomitant Hashimoto＇ s thyroiditis. Ultrasonography observed bilateral or unilateral asymmetric goiter （21/21, 100. 0% ） ,marked hypoechogenicity （21/21, 100. 0% ） with posterior acoustic enhancement （ 19/21, 90. 5% ） , heterogeneous echo texture with interspersed linear echogenic strands or intensive reticular echogenic strands or cloud echogenic, heterogeneous echo texture of thyroid gland （21/ 21, 100. 0%）, focal nodular hypoechoic （2/21, 9. 5%） with regular or irregular shape, increased vascularity （ 13/21 ; 61.9% ） and cervical lymphadenopathy （ 12/21, 57. 1% ）. Two cases involved the anterior cervical muscle and 1 infiltrated trachea. Rapidly enlarging cervical mass were found in 13 cases （ 13/21, 61.9% ）with associated compressive symptoms such as dyspnea, dysphagia and hoarseness. There was no any indisposed symptom in 3 cases. Conclusion PTL has some common ultrasonographic and clinical features, core needle biopsy should be warranted to prove PTL. Surgical resection should be considered when needed to reduce misdiagnosis.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2017年第37期2936-2939,共4页
National Medical Journal of China
关键词
淋巴瘤
甲状腺
超声
病理学
Thyroid
Lymphoma
Ultrasonography
Pathology
