原发性甲状腺淋巴瘤8例分析

Primary malignant lymphoma of thyroid gland: analysis of 8 cases

目的 分析原发性甲状腺淋巴瘤的误诊及术后并发症发生原因，探讨减少误诊及术后并发症的措施。方法 回顾我科1992-2005年住院治疗的8例原发性甲状腺淋巴瘤患者的临床资料并进行分析。结果 8例原发性甲状腺淋巴瘤术前均被误诊为甲状腺癌。常规病理检查确诊2例，常规病理加免疫组化确诊6例。术后并发症主要为声嘶。结论 原发性甲状腺淋巴瘤易发生临床误诊和病理误诊，全面掌握原发性甲状腺淋巴瘤的临床表现、重视细针穿刺和快速冰冻切片检查，结合免疫组化检测结果是减少原发性甲状腺淋巴瘤误诊的有效措施。原发性甲状腺淋巴瘤的早期诊断与综合治疗对减少术后并发症至关重要。

Objective To analyze the reasons of misdiagnosis and surgical complications of primary malignant lymphoma of thyroid gland （PLT）, and discuss the way to avoid them. Methods The clinical data of 8 patients suffering from PLT in our hospital from 1992 to 2005 were analyzed retrospectively. Results All the 8 patients were misdiagnosed as thyroid cancer before operation. After operation, 2 cases were diagnosed by routine pathologic methods, the other 6 cases were confirmed as PLT via immunohistochemical methods. The major postoperative complication was hoarseness. Conclusion The misdiagnosis of PLT is often encountered in both clinic and pathological examination. Effective measures to avoid the misdiagnosis of PLT include a comprehensive understanding of its clinical features, application of the fine-needle aspiration cytology, and the rapid biopsy combined with immunohistochemical methods. In order to decrease the surgical complication, early diagnosis and integrated treatment should be emphasized.