甲状腺淋巴瘤的病理、超声诊断特点与未分化癌的对比及临床意义

Comparison and clinical significance of pathologic and ultrasonographic features of thyroid lymphoma with undifferentiated carcinoma

目的 探究与分析甲状腺淋巴瘤的病理、超声诊断特点与未分化癌的对比及临床意义。方法 选取本院自2016年6月至2018年6月收治的经过手术病理证实的甲状腺淋巴瘤患者45例,另选择同时期收治的经过手术病理证实的甲状腺未分化癌40例,对比两组患者的病理表现及超声诊断结果。结果 甲状腺淋巴瘤组及甲状腺未分化癌组患者行超声检查时可见在回声(低回声/极低回声)、条索样或网格样高回声与否、钙化与否、囊性病变与否、后方回声增强与否方面具有明显差异,表现为甲状腺淋巴瘤组及甲状腺未分化癌组相比极低回声、条索样或网格样高回声及后方回声增强多见,钙化及囊性病变少见,差异有统计学意义(P<0.05)。甲状腺淋巴瘤组及甲状腺未分化癌组患者的病理学结果的异同:⑴甲状腺淋巴瘤组病例在行病理检查时可见其瘤细胞呈现出了单克隆性增殖的情况,表现出了瘤细胞大小以及形态方面的一致性;而甲状腺未分化癌组的病例呈现出了较为明显的细胞异质性,表现出了癌细胞在大小及形态方面的多形性。⑵甲状腺淋巴瘤组病例行病理检查时可见多合并存在着桥本甲状腺炎以及间质纤维化的改变等。⑶甲状腺未分化癌组病例多存在着不同程度的肿瘤性坏死的情况。结论 甲状腺淋巴瘤与甲状腺未分化癌患者在临床表现上虽然具有较高的相似性,但在病理特征上的表现具有明显的差异,通过给予超声检查可见甲状腺淋巴瘤与甲状腺未分化癌具有明显的差别,表现出了极低回声、条索样或者网络样高回声、后方回声增强等表现,同时表现出了缺乏钙化以及囊性变化等。

Objective To explore and analyze the comparison and clinical significance of pathologic and ultrasonographic features of thyroid lymphoma with undifferentiated carcinoma.Methods 45 cases of thyroid lymphoma with surgical and pathological confirmation treated in our hospital were selected from June 2016 to June 2018,during the same period 40 cases of undifferentiated thyroid carcinoma with surgical and pathological confirmation were selected.The pathological manifestations and ultrasonographic diagnostic results were compared between the two groups of patients.Results The thyroid lymphoma group and thyroid anaplastic carcinoma group had obvious ultrasonographic differences in terms of echoes(low echo/very low echo),sample line or grid high echo or not,calcification or not,cystic lesion or not,and posterior echo enhancement or not,characterized by very low echo,sample line or grid high echo,and posterior echo enhancement more seen in the thyroid lymphoma group,and rare calcification and cystic lesion,with statistically significant differences(P<0.05).The pathological results of patients in the thyroid lymphoma group and the undifferentiated thyroid cancer group were different:according to the pathological examination,the tumor cells in the thyroid lymphoma group presented monoclonal proliferation,showing the consistency of tumor cell size and morphology;however,the cases in the undifferentiated thyroid cancer group showed obvious cell heterogeneity and polymorphism in size and shape of the cancer cells.The pathological examination of the patients in the thyroid lymphoma group showed that there were many cases of hashimoto's thyroiditis and changes of interstitial fibrosis.More cases of tumor necrosis were found in the undifferentiated thyroid carcinoma group.Conclusions Patients with thyroid lymphoma and thyroid anaplastic carcinoma have high similarity in the clinical manifestations,but have obvious differences in the pathological features.Thyroid lymphoma and undifferentiated thyroid carcinoma have obvious differences in terms of ultrasonographic features,showed by extremely low echo,sample line or grid high echo,posterior echo enhancement,and lack of calcification and cystic change.