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OBJECTIVE: To evaluate the features of primary thyroid lymphoma (PTL) by ultrasonography (US) combined with contrast‑enhanced ultrasonography (CEUS). MATERIALS AND METHODS: In this retrospective study, 20 patients (8 male and 12 female) with PTL were evaluated by conventional US and among them, 10 patients underwent CEUS examination. The appearance of US features was classified into three types: Diffusive mass type, multiple nodular type and mixed type. The CEUS patterns included diffusive homogeneous enhancement and diffusive heterogeneous enhancement pattern. Parameters of CEUS time‑intensive curve were analyzed in primary tumor and involved lymph nodes compared to ipsilateral common carotid artery. RESULTS: Of 20 patients with PTL, 18 presented an enlarging neck mass that grew rapidly with an average duration of 3.2 months, and 17 were associated with Hashimoto’s thyroiditis. In conventional US, all patients had marked hypoechoic masses. Among them, 12 patients were diffusive mass type, 6 were multiple nodular type and 2 were mixed type. For CEUS patterns, 8 were diffusive homogeneous enhancement and 2 were diffusive heterogeneous enhancement. Necrosis areas were showed in diffuse heterogeneous pattern which were hardly seen in conventional US. In the quantitative analysis of CEUS parameters, the time to peak of time‑intensive curve in the primary tumors or involved lymph nodes was longer than that of the ipsilateral common carotid artery (P = 0.004). CONCLUSION: PTL mainly demonstrated as a diffusive mass type with marked hypoechogenecity on conventional US and diffusive homogeneous enhancement pattern on CEUS. And the heterogeneous enhancement pattern is also helpful for detecting necrosis areas of PTL.
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Objectives: The usage of Ultrasonography (US) in the diagnosis and management of patients with thyroid nodules and thyroid cancer is increasing. This method is also advocated for the pre-operative and post-operative diagnosis of cervical lymph node (LN) metastases. This article is trying to figure out the correlation between ultrasound features and pathological classification of thyroid carcinoma (TC). Materials and Methods: A total of 407 cases of patients with TC were selected from records between 2000 and 2006, which were used to analyze and compare the ultrasound features in different pathologic classification of TC. We grouped the US typing of TC according to the ultrasound features. Then, we implemented pre-surgery evaluation of TC by ultrasound assessment. Results: We classified these patients into six groups by ultrasound: (1) classical, (2) non-typical, (3) microminiaturize, (4) diffuse sclerosing, (5) medullary, and (6) undifferentiated. Ultrasonographic types of papillary TC: (1) classical, (2) microminiaturize, (3) diffuse, (4) cystic, (5) peripheral, (6) multi-nodules, (7) invasive, and (8) complicated Hashimoto. Grouping of the ultrasonic type of cervical LN metastasis: (1) cystic, (2) micro calcification, (3) macro-lymph, (4) microminiaturize, and (5) invasive. The ultrasound assessment of clinical staging had a higher sensitivity rate and specificity, and the accuracy rate of T stage was 93.9%. Conclusion: Ultrasound is a useful tool in the evaluation, characterization, quantification, and location of TC and cervical LN metastasis.