Different CT imaging findings between histological subtypes in patients with primary thyroid lymphoma

Ando, Tomohiro; Kato, Hiroki

doi:10.1007/s11547-022-01447-y

Cited by 6 publications

(6 citation statements)

References 47 publications

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“…A numerically higher proportion of patients with diffuse type/rich blood flow in thyroid lesions/grid echo in thyroid lesions/suspicious cervical lymph node metastasis was observed for patients with refractory/relapse events, although the difference was not significant. These trends were consistent with previous studies [ 8 , 21 ]. Compared with the nodular or mixed type, a diffuse pattern of thyroid lesions in PTL patients probably indicated a larger area of lymphoma-affected glands and a more progressive disease pattern.…”

Section: Discussionsupporting

confidence: 94%

The potential value of ultrasound in predicting local refractory/relapse events in primary thyroid lymphoma patients

Ji,

Gao,

Liu

et al. 2024

Cancer Imaging

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Background Primary thyroid lymphoma (PTL) is a rare malignant disorder, and ultrasound plays an important role in PTL diagnosis and follow-up surveillance. Prediction of refractory/relapse events in PTL patients is an essential issue, yet no ultrasonic PTL features have been discovered to be related to refractory/local relapse events. Methods From January 2008 to September 2022, newly diagnosed PTL patients in our center who underwent standard first-line treatment and received an ultrasound examination before treatment were enrolled. Data regarding patients’ clinical and sonographic features, as well as their therapeutic responses were collected. Subjects with an ideal prognosis were compared to those with refractory/relapse events. Results In total, 37 PTL patients were analyzed, including 26 with diffuse large B-cell lymphoma, 2 with follicular lymphoma and 9 with mucosa-associated lymphoid tissue lymphoma. During the median follow-up of 25 months, 30 patients obtained a complete response, 4 were refractory patients, and 3 experienced local relapse. No significant difference was detected in the baseline clinical characteristics between patients with an ideal prognosis and those with refractory/local relapse events. In terms of sonographic features, however, an event-free survival (EFS) curve comparison revealed that patients with bilobar enlargement (defined as an anterior-posterior diameter > 2.5 cm on both sides of thyroid lobes) had a poorer EFS than those without (P < 0.0001), and patients with diffuse type had a poorer EFS than those with mixed/nodular types (P = 0.043). No significant difference was observed in EFS between patients with or without signs of suspicious cervical lymph node metastasis, rich blood signal distribution or symptoms of trachea compression. Conclusions PTL patients with an anterior-posterior diameter > 2.5 cm for both thyroid lobes or PTL patients of the diffuse ultrasound type could be prone to refractory/local relapse events.

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Section: Discussionsupporting

confidence: 94%

The potential value of ultrasound in predicting local refractory/relapse events in primary thyroid lymphoma patients

Ji,

Gao,

Liu

et al. 2024

Cancer Imaging

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“…No research has yet reported that thyroid capsule invasion of invasive lymphomas was more likely to be detected by ultrasound. Ando et al reported that morphological patterns (diffuse or nodular type) and the invasion of surrounding tissues were useful CT imaging features in differentiating DLBCL from MALT lymphoma of the thyroid gland, similar to our results 30 …”

Section: Discussionsupporting

confidence: 91%

“…Ando et al reported that morphological patterns (diffuse or nodular type) and the invasion of surrounding tissues were useful CT imaging features in differentiating DLBCL from MALT lymphoma of the thyroid gland, similar to our results. 30 PTL combined with thyroid cancer is very rare and only a few cases have been reported in the literature until now. 31 In this study, we observed five PTL cases with PTC, maximum age 62, and pathological types of four cases were MALT lymphoma with ultrasound pattern of diffuse type.…”

Section: Discussionmentioning

confidence: 99%

Multimodal Sonographic Appearance and Survival Outcomes of 69 Cases of Primary Thyroid Lymphoma Over 10 Years

Peng

Yang

Yao

et al. 2022

J of Ultrasound Medicine

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Objectives To investigate ultrasound appearance and the survival outcomes for patients with primary thyroid lymphoma (PTL). Methods Ultrasonic images and clinical characteristics from pathologically confirmed 69 PTL patients (2008–2019) were retrospectively analyzed. The clinical characteristics, ultrasonic characters, and prognostic factors were analyzed. Survival curves were plotted using the Kaplan–Meier method. Univariate and multivariate analyses were performed. Results Of the 69 study patients, 23 were indolent PTL and 46 were aggressive PTL. Age (>70 years old) and elevated lactate dehydrogenase levels were statistically different clinical features between aggressive and indolent PTL. From ultrasonic images, 34 cases were nodular, 11 diffuse, and 24 mixed pattern. Mixed types displayed high invasiveness (45.7%) while diffuse types displayed higher inertness (39.1%), with statistically significant differences (P = .000). Invaded thyroid capsule and increased chaotic vascularity also showed significant differences between aggressive and indolent PTL. We also observed statistical difference in overall survival rates between aggressive and indolent PTL (P = .032). Single factor K‐M analyses showed that age >70 years, aggressive pathology, and Ki67 >30% were positively correlated with the risk of poor PTL survival (P < .05). Conclusions Multimodal ultrasound provides accurate ultrasonographic information and facilitates PTL invasiveness diagnostics for improved clinical treatment. In addition, PTL patients aged >70 years, with aggressive pathology, and Ki67 >30% were more likely to have a poor survival outcome.

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“…It is the opinion of the authors that the shorter data acquisition time in patients with often some form of respiratory distress results in more accurate images. On a recent study including 18 patients with PTL, the tumour maximum diameter, morphological patterns (diffuse or nodular type), thickening of the isthmus, invasion of surrounding tissues, regional lymphadenopathy, and preserved peripheral thyroid tissue were useful CT imaging features in differentiating DLBCL from MALT lymphoma of the thyroid gland [16]. On MRI, PTL tends to be homogenous, similar to its CT aspect [17].…”

Section: Diagnosismentioning

confidence: 99%

Thyroid lymphoma

Rovira

Carroll

Simó

2023

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of reviewTo highlight recent advances in our understanding of the epidemiology, incidence, evaluation, management and outcomes of primary thyroid lymphoma (PTL), and highlight the indications and limitations of surgery. Recent findingsThe differential diagnosis of a rapidly enlarging thyroid mass with or without obstructive symptoms should include PTL and anaplastic thyroid cancer. When PTL is suspected, initial investigations should include blood tests and ultrasound-guided biopsy preferably core need biopsy to allow tissue typing and immunohistochemistry analysis. Systemic imaging with FDG PET-CT is required for staging. Surgery is not recommended for treatment purposes and should be reserved for diagnosis and airway management. Treatment includes chemotherapy and radiotherapy and offer an excellent prognosis. SummaryPTL is a rare malignancy making diagnosis and management challenging. Initial investigations of suspected PTL should include blood tests and ultrasound-guided biopsy, preferably core needle biopsy and systemic imaging is required for staging. Surgery is reserved for diagnosis and airway management. Chemotherapy and radiotherapy are the treatment of choice.

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Different CT imaging findings between histological subtypes in patients with primary thyroid lymphoma

Cited by 6 publications

References 47 publications

The potential value of ultrasound in predicting local refractory/relapse events in primary thyroid lymphoma patients

The potential value of ultrasound in predicting local refractory/relapse events in primary thyroid lymphoma patients

Multimodal Sonographic Appearance and Survival Outcomes of 69 Cases of Primary Thyroid Lymphoma Over 10 Years

Thyroid lymphoma

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