Ultrasound signs of 12 cases of primary thyroid lymphoma

Objective To investigate the ultrasound signs of primary thyroid lymphoma, so as to improve the accuracy of the diagnosis by ultrasound physician. Methods Ultrasound images of 12 patients with primary thyroid lymphoma (PTL) confirmed by biopsy or surgical pathology from January 2013 to March 2018 at the Affiliated Tumor Hospital of Zhengzhou University were retrospectively analyzed. And ultrasound signs such as morphology, structure, margin, internal echo level, focal strong echo, color Doppler flow, posterior echo level, and cervical lymph node echo characteristics of the 12 patients were analyzed according to ACR-TIRADS guidelines. Results In two-dimensional ultrasound examination, most of the PTL showed diffuse volume of the bilateral thyroid or increased unilateral leaf volume, including 3 cases (25.0%) of bilateral lobe lesions and 9 cases (75.0%) of unilateral lobe lesions. There were 12 cases (100.0%) with nodular aspect ratio<1, 9 cases (75.0%) with solid structure in the sonogram, 3 cases (25.0%) with mixed type. There were 5 cases (41.7%) with smooth edge signs, and 7 cases (58.3%) with ambiguity edge signs. Twelve cases (100.0%) were with hypoechoic internal echo, and 1 case (8.3%) was with focal strong echoes and 11 cases were with focal strong echoes (91.7%). Abundant blood flows in the nodules were presented in 10 cases (83.3%), and 2 cases (16.7%) had blood flow signals; all echoes in the posterior nodules were enhanced; 9 cases were associated with cervical lymph nodes. Conclusions PTL sonograms have certain characteristics. When the sonographer encounters typical ultrasound signs during the examination, the possibility of thyroid lymphoma should be considered. Key words: Thyroid lymphoma; ACR-TIRADS guidelines; Ultrasound signs