Diagnostic value of ultrasonic pattern in primary thyroid lymphoma

doi:10.3877/cma.j.issn.1672-6448.2022.05.010

Abstract

Abstract:

Objective

To explore the diagnostic value of ultrasonic pattern in primary thyroid lymphoma (PTL).

Methods

The 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.

Results

The 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).

Conclusion

Ultrasound 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.

Key words: Thyroid, Primary lymphoma, Ultrasonic pattern

Chanjuan Peng, Xiangkai Kong, Junzhou Wu, Shuailing Peng, Dong Xu, Chen. Department of Ultrasound Yang. Diagnostic value of ultrasonic pattern in primary thyroid lymphoma[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(05): 447-453.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2022.05.010

https://chaosheng.cma-cmc.com.cn/EN/Y2022/V19/I05/447

Figures/Tables 6

临床特征	DLBCL（n=37）	MALT（n=21）	统计值	P值
性别［例（%）］			χ²=1.312	0.275
男	12（32.4）	10（47.6）
女	25（67.6）	11（52.4）
年龄（岁， $x ¯$ ±s）	64.05±10.8	59.76±9.5	t=1.515	0.135
桥本甲状腺炎^a［例（%）］			χ²=0.062	0.804
无	6（23.1）	2（14.3）
有	20（76.9）	12（85.7）
甲状腺功能减退^a［例（%）］			χ²=3.731	0.134
无	19（67.9）	14（93.3）
有	9（32.1）	1（6.7）
诊断方式［例（%）］			χ²=1.197	0.385
粗针穿刺	14（37.8）	5（23.8）
手术	23（62.2）	16（76.2）
CD20^a［例（%）］			χ²=1.499	0.221
-	0（0）	2（11.1）
+	34（100）	16（88.9）
CD3^a［例（%）］			χ²=5.086	0.024
-	29（87.9）	10（55.6）
+	4（12.1）	8（44.4）
Ki67^a［例（%）］			χ²=38.839	＜0.001
＞30%	29（90.6）	0（0）
≤30%	3（9.4）	18（100）
治疗方式［例（%）］			χ²=0.207	1.000
单一治疗	18（48.6）	10（47.6）
联合治疗	17（45.9）	10（47.6）
未治疗	2（5.4）	1（4.8）

临床特征	DLBCL（n=37）	MALT（n=21）	统计值	P值
性别［例（%）］			χ²=1.312	0.275
男	12（32.4）	10（47.6）
女	25（67.6）	11（52.4）
年龄（岁， $x ¯$ ±s）	64.05±10.8	59.76±9.5	t=1.515	0.135
桥本甲状腺炎^a［例（%）］			χ²=0.062	0.804
无	6（23.1）	2（14.3）
有	20（76.9）	12（85.7）
甲状腺功能减退^a［例（%）］			χ²=3.731	0.134
无	19（67.9）	14（93.3）
有	9（32.1）	1（6.7）
诊断方式［例（%）］			χ²=1.197	0.385
粗针穿刺	14（37.8）	5（23.8）
手术	23（62.2）	16（76.2）
CD20^a［例（%）］			χ²=1.499	0.221
-	0（0）	2（11.1）
+	34（100）	16（88.9）
CD3^a［例（%）］			χ²=5.086	0.024
-	29（87.9）	10（55.6）
+	4（12.1）	8（44.4）
Ki67^a［例（%）］			χ²=38.839	＜0.001
＞30%	29（90.6）	0（0）
≤30%	3（9.4）	18（100）
治疗方式［例（%）］			χ²=0.207	1.000
单一治疗	18（48.6）	10（47.6）
联合治疗	17（45.9）	10（47.6）
未治疗	2（5.4）	1（4.8）

超声特征	DLBCL（n=37）	MALT（n=21）	统计值	P值
超声分型			χ²=14.305	0.001
弥漫型	2（5.4）	9（42.9）
肿块型	17（46.0）	9（42.9）
混合型	18（48.6）	3（14.3）
超声诊断			χ²=1.118	0.290
恶性	32（86.5）	15（71.4）
良性	5（13.5）	6（28.6）
非对称肿大			χ²=1.643	0.269
无	13（35.1）	11（52.4）
有	24（64.9）	10（47.6）
肿块部位			χ²=0.989	0.856
左叶	8（21.6）	3（14.3）
右叶	6（16.2）	5（23.8）
双侧叶	21（56.8）	12（57.1）
峡部^a	2（5.4）	1（4.8）
肿块内血供			χ²=4.410	0.231
0级	5（13.5）	4（19）
1级	2（5.4）	4（19）
2级	25（67.6）	9（43）
3级	5（13.5）	4（19）
周围淋巴结异常			χ²=2.788	0.158
无	20（54.1）	16（76.2）
有	17（45.9）	5（23.8）
肿块最大径（肿块型）	48.18±16.30	43.36±14.34	t=0.797	0.432
边界不清（肿块型）			-	0.630
无	10（58.8）	5（55.6）
有	7（41.2）	4（44.4）
边缘不规则（肿块型）			-	0.342
无	10（58.8）	6（66.7）
有	7（41.2）	3（33.3）
显著低回声（肿块型）			-	0.346
无	0（0）	1（11.1）
有	17（100）	8（88.9）
内部钙化（肿块型）			-	1.000
无	15（88.2）	8（88.9）
有	2（11.8）	1（11.1）
结节内血供（肿块型）			χ²=12.021	0.003
0级	1（5.9）	2（22.2）
1级	1（5.9）	4（44.4）
2级	13（76.4）	2（22.2）
3级	2（11.8）	1（11.1）
甲状腺包膜受侵（肿块型）			-	0.013
无	10（58.8）	9（100）
有	7（41.2）	0（0）

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