【摘要】 目的:对比原发性甲状腺淋巴瘤(PTL)和甲状腺未分化癌(ATC)的临床病理及超声特征。方法:回顾性分析24例PTL患者和10例ATC患者的临床病理资料和超声图像,评估差异图像特征鉴别诊断PTL的诊断效能。结果:声音嘶哑更常见于ATC组(P=0.048),PTL组多合并桥本甲状腺炎(P=0.008),两组在发病年龄、性别比、其他临床症状、淋巴结转移和远处转移上均无显著差异。ATC组肿瘤均呈结节型生长,PTL组可表现为弥漫型(37.5%)、结节型(50%)、混合型(12.5%)。PTL组内部极低回声、后方回声增强更常见,而钙化、囊性变更常见于ATC组(P<0.05)。两组在病灶大小、边界、形态、条索状或网格状高回声、血流、包膜浸润和淋巴结肿大等方面差异无统计学意义(P>0.05)。病灶类型、内部回声为极低回声、无钙化、无囊性变、后方回声增强等特征诊断PTL的AUC分别为0.750、0.938、0.879、0.658及0.979。结论:PTC与ATC虽然有很多相似之处,但伴随桥本甲状腺炎、内部回声为极低回声、钙化和囊性变少见、后方回声增强等超声特征有助于鉴别诊断。更多还原

【Abstract】 Objective: To compare the clinicopathologic characteristics and ultrasonographic features between primary thyroid lymphoma(PTL) and anaplastic thyroid cancer(ATC). Methods: The clinicopathologic characteristics and sonographic findings of 24 PTL patients and 10 ATC patients were retrospectively reviewed. The diagnostic effcacy of differentiated ultrasonographic characteristics was evaluated. Results: Hoarseness was seen more frequently in ATC group(P =0.048).Associated Hashimoto’s thyroiditis occurred more frequently in PTL group(P=0.008). There was no significant difference in age,female-to-male ratio, other symptoms, lymphatic metastasis and distant metastasis between the two groups. While all ATC cases presented with nodular type(100.0%), three ultrasound patterns were observed in PTL including diffuse type(37.5%),nodular type(50%) and mixed type(12.5%). Markedly hypoechogenicity and enhanced posterior echo were seen more frequently in PTL group, while calcification and cystic changes were significantly more common in ATC group(P<0.05). There was no statistically significant difference in nodular size, margin, shape, strip-like or grid-like hyperechogenicity, vascularity, capsular invasion and cervical lymph node enlargement on sonography between the two groups. The AUC of ultrasound patterns,markedly hypoechogenicity, enhanced posterior echo, absence of calcification, and absence of cystic change in prediction of PTL was 0.750, 0.938, 0.879, 0.658, and 0.979, respectively. Conclusion: Although there are many similarities between PTL and ATC, the presence of Hashimoto’s thyroiditis, markedly hypoechogenicity, rare calcification and cystic change, and enhanced posterior echo is useful for distinguishing PTL from ATC.更多还原