甲状腺淋巴瘤临床病理及超声特征分析  

Clinic pathological and ultrasonographic features of primary thyroid lymphoma

作　　者：张秀梅[1] 农琳[2] 冉旭[1] 李萌[1] 

机构地区：[1]北京大学第一医院超声科,100034 [2]北京大学第一医院病理科,100034

出　　处：《中华医学杂志》2017年第37期2936-2939,共4页National Medical Journal of China

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.

关 键 词：淋巴瘤 甲状腺 超声 病理学 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]