原发性甲状腺淋巴瘤的超声表现特征分析  

Analysis of ultrasonographic features of primary thyroid lymphomas

作　　者：张崴[1] 陈琦[1] 刘宏[1] ZHANG Wei;CHEN Qi;LIU Hong(Department of Ultrasonography,the Affiliated Tumor Hospital of Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi830011,China)

机构地区：[1]新疆医科大学附属肿瘤医院超声科,新疆乌鲁木齐830011

出　　处：《中国医药导报》2020年第28期144-146,164,F0004,共5页China Medical Herald

基　　金：新疆维吾尔自治区自然科学基金资助项目(2017D01C394)。

摘　　要：目的总结原发性甲状腺淋巴瘤(PTLs)各类型声像图特征,探讨其诊断及鉴别诊断要点。方法回顾性分析2008年8月—2019年5月于新疆医科大学附属肿瘤医院收治住院行术前超声检查后经穿刺活检或手术病理证实为PTLs患者65例,探讨其超声分型及声像图特征。结果65例PTLs患者病灶中,39例(60.0%)为弥漫型,患者甲状腺不同程度肿大,包膜完整未被破坏,甲状腺实质回声弥漫性减低,呈不均匀性低回声至极低回声。所有弥漫型PTLs患者病灶内部均未见钙化及液化。28例(71.8%)患者病灶中可检出较丰富血流信号。22例(56.4%)中可见颈部淋巴结肿大。26例(40.0%)为非弥漫型,共47个病灶,其中11例为单发病灶,15例为多发病灶,16例(61.5%)为低回声,10例(38.5%)为极低回声。22例(84.6%)病灶形态不规则,低回声或极低回声病灶内可见多种形态中高回声,后方回声增强。19例(73.1%)患者病灶中可见丰富血流。19例(73.1%)中可见颈部淋巴结肿大。结论PTLs具有一定的超声特征表现,必要时行穿刺活检或切取组织标本进行活检病理证实,以免误诊及漏诊。Objective To summarize the characteristics of each type of image for primary thyroid lymphomas(PTLs),and to discuss the diagnosis and differential diagnosis of PTLs.Methods From August 2008 to May 2019,a total of 65 patients with PTLs confirmed by biopsy or pathology after preoperative ultrasound examination were retrospectively analyzed.The ultrasonic classification and sonographic features were discussed.Results Of the 65 patients with PTLs,39 cases(60.0%)were diffuse type.The thyroid gland was enlarged in varying degrees,the capsule was intact,and the echo of thyroid parenchyma was diffusely decreased,showing heterogeneous hypoechoic to extremely low echo.No calcification or liquefaction was found in the lesions of all patients with diffuse PTLs.Abundant blood flow signals were detected in 28 cases(71.8%).Cervical lymph node enlargement was found in 22 cases(56.4%).26 cases(40.0%)were non diffuse type with 47 lesions,of which 11 cases were single lesion,15 cases were multiple lesions,16 cases(61.5%)were hypoechoic,and 10 cases(38.5%)were extremely hypoechoic.22 cases(84.6%)had irregular shape,hypoechoic or extremely hypoechoic lesions.19 cases(73.1%)had abundant blood flow.Cervical lymph node enlargement was found in 19 cases(73.1%).Conclusion PTLs have certain ultrasonographic features.If necessary,biopsy or biopsy should be performed to avoid misdiagnosis and missed diagnosis.

关 键 词：甲状腺 淋巴瘤 病理诊断 超声 

分 类 号：R736.1[医药卫生—肿瘤]