4例甲状腺淋巴瘤患者的诊治体会

Diagnosis and treatment of 4 cases of thyroid lymphoma

目的:探究原发性甲状腺淋巴瘤的临床诊断及治疗原则。方法:回顾性分析2011年1月至2016年12月本院收治的4例原发性甲状腺淋巴瘤患者资料,对临床特点、手术方法及预后情况进行总结。结果:1例术前拟行双叶甲状腺近全切除术,术中行全甲切除术,术后病理诊断为右叶甲状腺B细胞性淋巴瘤;1例行右叶甲状腺肿块空心针活检术,病理诊断为右叶甲状腺恶性淋巴瘤;1例行左叶甲状腺肿块空心针活检术,病理诊断为右甲状腺弥漫性大B细胞淋巴瘤;1例行右叶甲状腺细针穿刺活检术,未能明确诊断,因肿块巨大局部存在压迫症状行右叶甲状腺全切+峡部切除+左叶甲状腺部分切除+峡部甲状腺切除术+中央区淋巴结清扫+右下甲状旁腺移植术,术后病理诊断为右叶甲状腺弥漫性大B细胞淋巴瘤。4例患者术后随访12~34个月,随访期间所有患者均存活。结论:原发性甲状腺淋巴瘤患者主要依靠穿刺活检或手术明确诊断,及时行手术治疗是提高患者生存率的前提。

Objective：To explore the clinical diagnosis and treatment of primary thyroid lymphoma.Methods：The data of 4 cases of primary thyroid lymphoma admitted from our hospital from 2011.1 to 2016.12 were analyzed retrospectively.The clinical features,surgical methods and prognosis were summarized.Results：One patient underwent total thyroidectomy.The pathologic diagnosis was right thyroid B-cell lymphoma.One patient underwent hollow needle biopsy with right thyroid tumor,the pathological diagnosis of right malignant lymphoma;1 case of left lobe thyroid tumor hollow needle biopsy,pathological diagnosis of right thyroid diffuse large B-cell lymphoma;1 case of right lobe thyroid tumor needle biopsy,undiagnosed,nderwent total thyroidectomy＋central lymph node dissection ＋ right lower parathyroid transplantation,the pathological diagnosis of the right lobe thyroid diffuse large B cells Lymphoma.Four patients were followed up for 12 to 34 months.All patients survived during follow-up.Conclusion：Primary thyroid lymphoma patients rely mainly on biopsy or surgical diagnosis,prompt surgical treatment is the precondition for improve the survival rate of patients.