超声分型对原发性甲状腺淋巴瘤的诊断价值

目的探讨超声分型对原发性甲状腺淋巴瘤（PTL）的诊断价值。 方法回顾性分析浙江省肿瘤医院2010年1月至2019年12月病理证实的58例PTL患者的超声图像特点及临床特征。以病理结果为金标准，分析并比较最常见的2种病理类型［弥漫性大B细胞淋巴瘤（DLBCL）和黏膜相关淋巴组织淋巴瘤（MALT）］超声图像特点及临床特征的差异，采用χ²检验比较2种病理类型的超声特征差异。 结果58例病例病理类型均为非霍奇金淋巴瘤，19例经超声引导下粗针穿刺活检，39例经手术获得组织病理。其中DLBCL 37例，MALT 21例。根据超声图像特点，分为肿块型26例、弥漫型11例、混合型21例。DLBCL中超声分型为混合型的比例最高（48.6%），MALT中超声分型为混合型的比例最低（14.3%），两者比较差异具有统计学意义（χ²=14.305，P=0.001）。与MALT对比，肿块型DLBCL血流信号分级更高，并且包膜受侵比例更高（41.2% vs 0），差异有统计学意义（χ²=12.021，P=0.003；P=0.013）。 结论超声检查能够较准确提供PTL的声像图特征，结合临床表现及超声分型可以辅助诊断PTL的病理类型，对临床治疗具有指导意义。

Diagnostic value of ultrasonic pattern in primary thyroid lymphoma

ObjectiveTo explore the diagnostic value of ultrasonic pattern in primary thyroid lymphoma (PTL). MethodsThe ultrasonic images and clinical characteristics of 58 patients with pathologically confirmed PTL from January 2010 to December 2019 at Zhejiang Cancer Hospital were retrospectively analyzed. Pathology results were used as the gold standard to analyze and compare the two most common pathological types of PTL: diffuse large B cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue lymphoma (MALT). The ultrasonic characteristics were compared by χ² between DLBCL and MALT. ResultsThe pathological type of all the 58 patients was non-Hodgkin's lymphoma, among whom 19 underwent ultrasound-guided needle biopsy, and 39 underwent surgical operation. There were 37 cases of DLBCL and 21 cases of MALT. According to the ultrasonic characteristics, 26 cases were nodular type, 11 were diffused type, and 21 were mixed type. The mixed type was more often seen in DLBCL (up to 48.6%), and less frequently seen in MALT (14.3%) (χ²=14.305, P=0.001). Nodular pattern DLBCL had a significantly higher blood flow signal grade and higher percentage of thyroid capsule invasion (41.2% vs 0), which were statistically different from those of MALT (χ²=12.021, P=0.003; P=0.013). ConclusionUltrasound can accurately reveal the ultrasonographic characteristics of PTL. The combination of clinical features with ultrasonic classification can assist in the diagnosis of the pathology of primary thyroid lymphoma, which has guiding significance for clinical treatment.