ObjectiveTo analyze clinical manifestation, diagnosis, therapy, and prognosis of primary thyroid lymphoma.
MethodFrom April 2012 to September 2015, the clinical data of 9 patients with primary thyroid lymphoma admitted to The Affiliated Hospital of Xuzhou Medical College, including clinical manifestation, diagnosis procedure, treatment project, and prognosis, were reviewed retrospectively.
ResultsThe thyroids or nodules of 4 patients increased rapidly in 1-3 months, with the surrounding tissues and organs oppression symptoms. The preoperative examination revealed that there were 5 patients with swollen lymph nodes. Eight patients were received preoperative thyroid function examination, there were 4 patients with subclinical hypothyroidism, 4 patients with rose TSH, 6 patients with rose thyroglobulin antibody. There were 5 cases of primary thyroid lymphoma associated with Hashimoto thyroiditis. Eight patients were underwent surgical treatment in our hospital, 1 patient was underwent surgery in the other hospital. The results of pathological histology showed that 5 patients with mucosa associated lymphadenoma were stageⅠE, 3 patients with diffuse large B cell lymphoma were stageⅠE, 1 patient with diffuse large B cell lymphoma was stageⅡE. Two patients with diffuse large B cell lymphoma were received chemotherapy, the scheme was CHOP and COP respectively. Seven patients were received follow-up, the follow-up time was 2-42 months, the median follow-up time was 20 months, all of them were survived.
ConclusionsPrimary thyroid lymphoma should be considered for patients with rapid growth of thyroid mass in a short term, which relies on the histopathologic and immunohistochemical diagnosis finally. The individualized treatment should be performed for primary thyroid lymphoma according to pathological classification.
Primary thyroid lymphoma (PTL) is a rare extranodal lymphoma closely associated with Hashimoto’s thyroiditis. Because the sonographic features of PTL overlap with those of anaplastic thyroid carcinoma, papillary thyroid carcinoma, and inflammatory thyroid diseases, early diagnosis remains challenging. This paper reviews the epidemiology, clinicopathological features, and ultrasonic manifestations of PTL, focusing on the roles of multimodal ultrasound and ultrasound-guided core needle biopsy in early identification, subtype prediction, and progression monitoring. It aims to provide differential diagnostic insights for sonologists and references for clinical decision-making and therapeutic efficacy evaluation.
