协和医学杂志

2014, v.5(01) 3-7

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超声引导组织活检对原发性甲状腺淋巴瘤的诊断价值
Ultrasound-guided Core-needle Biopsy in the Diagnosis of Primary Thyroid Lymphoma

朱庆莉;姜玉新;李文波;王铭;夏宇;
ZHU Qing-li;JIANG Yu-xin;LI Wen-bo;WANG Ming;XIA Yu;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

摘要(Abstract):

目的探讨原发性甲状腺淋巴瘤(primary thyroid lymphoma,PTL)的超声特征及超声引导甲状腺活检的诊断价值。方法回顾性分析2003年至2013年北京协和医院22例经病理证实的PTL患者的临床资料(年龄32~81岁,中位年龄61岁)、超声声像图表现及活检方式,将PTL超声表现分为3型,即弥漫型、结节型和混合型。结果 22例PTL患者的主要病理类型为黏膜相关淋巴组织B细胞淋巴瘤(45.5%,10/22)和弥漫性大B细胞淋巴瘤(36.4%,8/22)。16例PTL患者(72.7%)首发症状为颈部肿物近期明显增大。22例PTL患者中16例(72.7%)超声诊断为恶性或可疑恶性,6例(27.3%)超声诊断为良性。10例行超声引导细针抽吸活检,其中仅2例诊断可疑PTL;9例行超声引导组织活检,其中8例获得明确病理诊断。15例PTL患者接受外科手术活检,获得病理诊断。PTL超声声像图特征分为弥漫型(45.5%,10/22)、结节型(40.9%,9/22)和混合型(13.6%,3/22)。结论超声声像图特征有助于PTL诊断,尤其是对有近期颈部肿物迅速增大病史的患者。超声引导组织活检安全、准确,是诊断PTL的首选方法。
Objective To explore the sonographic findings of primary thyroid lymphoma( PTL) and evaluate the role of ultrasound-guided core-needle biopsy in diagnosing this disease.Methods The clinical data,sonographic,and biopsy modes of 22 patients( age range,32-81 years; median,61 years) with pathologically confirmed PTL were retrospectively analyzed.The sonographic findings of PTL were divided into three types:diffuse type,nodular type,and mixed type.Results The main pathologic types of PLT in these 22 patients included mucosa-associated lymphoid tissue lymphoma( n = 10,45.5%) and diffuse large B-cell lymphoma( n = 8,36.4%).In 16 patients( 72.7%),the initial symptom was enlarged neck mass.Among the 22 patients with a diagnosis of PTL,16( 72.7%) were sonographically diagnosed as malignancies or suspected malignancies and 6( 27.3%) as benign lesions.In 10 patients who had received ultrasound-guided fine-needle aspiration biopsy,only 2 were diagnosed as suspected malignancies.In 9 patients who had received ultrasound-guided core-needle biopsy,8( 88.9%) achieved definitive pathological diagnoses.In 15 patients who had undergone surgical biopsy,pathological diagnoses were obtained in all of them.The distribution of the sonographic findings of PTL was asfollows:diffuse type,n = 10( 45.5%); nodular type,n = 9( 40.9%); and mixed types,n = 3( 13.6%).Conclusions Ultrasonography is helpful for PTL diagnosis,especially in patients with rapid thyroid enlargement.Ultrasound-guided core-needle biopsy is safe and accurate,and therefore remains a preferred method for diagnosing thyroid lymphoma.

关键词(KeyWords): 淋巴瘤;甲状腺肿瘤;甲状腺活检;超声引导
lymphoma;thyroid neoplasm;thyroid biopsy;ultrasound guidance

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基金项目(Foundation): 国家高技术研究发展计划(863计划)(2006AA02Z4B3)

作者(Author): 朱庆莉;姜玉新;李文波;王铭;夏宇;
ZHU Qing-li;JIANG Yu-xin;LI Wen-bo;WANG Ming;XIA Yu;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

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