- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
MA Buyun,
Email: maby@scu.edu.cn
Primary thyroid lymphoma (PTL) is a rare extranodal lymphoma closely associated with Hashimoto’s thyroiditis. Because the sonographic features of PTL overlap with those of anaplastic thyroid carcinoma, papillary thyroid carcinoma, and inflammatory thyroid diseases, early diagnosis remains challenging. This paper reviews the epidemiology, clinicopathological features, and ultrasonic manifestations of PTL, focusing on the roles of multimodal ultrasound and ultrasound-guided core needle biopsy in early identification, subtype prediction, and progression monitoring. It aims to provide differential diagnostic insights for sonologists and references for clinical decision-making and therapeutic efficacy evaluation.
Citation： CHEN Juanmei, MA Buyun. Research progress on ultrasonic application in primary thyroid lymphoma. West China Medical Journal, 2026, 41(9): 1538-1544. doi: 10.7507/1002-0179.202601148 Copy
Copyright ? the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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| 2. | Xiang N, Dong F, Zhan X, et al. Incidence and prognostic factors of primary thyroid lymphoma and construction of prognostic models for post-chemotherapy and postoperative patients: a population-based study[J]. BMC Endocr Disord, 2021, 21(1): 68. |
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| 5. | Xiao L, Zhao Z, Zhou L, et al. Clinical and imaging features of primary thyroid MALT lymphoma[J]. Front Oncol, 2025, 15: 1498609. |
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| 22. | Gu L, Cui N, Wang Y, et al. Comparison of sonographic characteristics of primary thyroid lymphoma and anaplastic thyroid carcinoma[J]. J Thorac Dis, 2017, 9(11): 4774-4784. |
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| 24. | Ota H, Ito Y, Matsuzuka F, et al. Usefulness of ultrasonography for diagnosis of malignant lymphoma of the thyroid[J]. Thyroid, 2006, 16(10): 983-987. |
| 25. | Xia Y, Wang L, Jiang Y, et al. Sonographic appearance of primary thyroid lymphoma-preliminary experience[J]. PLoS One, 2014, 9(12): e114080. |
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- 1. Stein SA, Wartofsky L. Primary thyroid lymphoma: a clinical review[J]. J Clin Endocrinol Metab, 2013, 98(8): 3131-3138.
- 2. Xiang N, Dong F, Zhan X, et al. Incidence and prognostic factors of primary thyroid lymphoma and construction of prognostic models for post-chemotherapy and postoperative patients: a population-based study[J]. BMC Endocr Disord, 2021, 21(1): 68.
- 3. 楊磊, 曾立潔, 葉進, 等. 34 例原發性甲狀腺淋巴瘤的臨床特征及預后分析[J]. 中華血液學雜志, 2024, 45(5): 495-499.
- 4. Xue X, Wu L, Zhang J, et al. Ultrasound scanning in diagnosing primary thyroid lymphoma[J]. Clin Hemorheol Microcirc, 2024, 88(3): 385-393.
- 5. Xiao L, Zhao Z, Zhou L, et al. Clinical and imaging features of primary thyroid MALT lymphoma[J]. Front Oncol, 2025, 15: 1498609.
- 6. De Vito P, Incerpi S, Pedersen JZ, et al. Thyroid hormones as modulators of immune activities at the cellular level[J]. Thyroid, 2011, 21(8): 879-890.
- 7. Hamdy O, Saleh GA, Ayman Selim R, et al. Diagnosis and treatment outcomes of primary lymphoma of the thyroid gland[J]. Discov Oncol, 2025, 16(1): 1568.
- 8. Derringer GA, Thompson LD, Frommelt RA, et al. Malignant lymphoma of the thyroid gland: a clinicopathologic study of 108 cases[J]. Am J Surg Pathol, 2000, 24(5): 623-639.
- 9. Watanabe N, Noh JY, Narimatsu H, et al. Clinicopathological features of 171 cases of primary thyroid lymphoma: a long-term study involving 24553 patients with Hashimoto’s disease[J]. Br J Haematol, 2011, 153(2): 236-243.
- 10. Pedersen RK, Pedersen NT. Primary non-Hodgkin’s lymphoma of the thyroid gland: a population based study[J]. Histopathology, 1996, 28(1): 25-32.
- 11. Holm L, Blomgren H, L?whagen T. Cancer Risks in Patients with Chronic Lymphocytic Thyroiditis[J]. N Engl J Med, 1985, 312(10): 601-604.
- 12. Saxena A, Alport EC, Moshynska O, et al. Clonal B cell populations in a minority of patients with Hashimoto’s thyroiditis[J]. J Clin Pathol, 2004, 57(12): 1258-1263.
- 13. Skacel M, Ross CW, Hsi ED. A reassessment of primary thyroid lymphoma: high-grade MALT-type lymphoma as a distinct subtype of diffuse large B-cell lymphoma[J]. Histopathology, 2000, 37(1): 10-18.
- 14. Kariya A, Tachibana T, Hiramatsu Y, et al. Primary thyroid lymphoma: clinical factors predicting the possibility of diffuse large B-cell lymphoma[J]. Ear Nose Throat J, 2026, 105(7): 427-433.
- 15. Chen E, Wu Q, Jin Y, et al. Clinicopathological characteristics and prognostic factors for primary thyroid lymphoma: report on 28 Chinese patients and results of a population-based study[J]. Cancer Manag Res, 2018, 10: 4411-4419.
- 16. Graff-Baker A, Roman SA, Thomas DC, et al. Prognosis of primary thyroid lymphoma: demographic, clinical, and pathologic predictors of survival in 1, 408 cases[J]. Surgery, 2009, 146(6): 1105-1115.
- 17. Kuribayashi-Hamada Y, Ishibashi M, Tatsuguchi A, et al. Clinicopathologic characteristics and A20 mutation in primary thyroid lymphoma[J]. J Nippon Med Sch, 2022, 89(3): 301-308.
- 18. Brandenstein M, Wiesinger I, Künzel J, et al. Multiparametric sonographic imaging of thyroid lesions: chances of B-mode, elastography and CEUS in relation to preoperative histopathology[J]. Cancers (Basel), 2022, 14(19): 4745.
- 19. 許立龍, 李世巖, 朱江, 等. 高頻超聲聯合超聲引導下粗針穿刺活檢在診斷原發性甲狀腺淋巴瘤中的應用價值[J]. 中華耳鼻咽喉頭頸外科雜志, 2021, 56(8): 858-862.
- 20. Zhang X, Wei B, Nong L, et al. The usefulness of serial ultrasound in thyroid mucosa-associated lymphoid tissue lymphoma[J]. Front Endocrinol (Lausanne), 2022, 13: 1054584.
- 21. 張秀梅, 農琳, 冉旭, 等. 甲狀腺淋巴瘤臨床病理及超聲特征分析[J]. 中華醫學雜志, 2017, 97(37): 2936-2939.
- 22. Gu L, Cui N, Wang Y, et al. Comparison of sonographic characteristics of primary thyroid lymphoma and anaplastic thyroid carcinoma[J]. J Thorac Dis, 2017, 9(11): 4774-4784.
- 23. 陸弘逾, 徐又海, 許浩, 等. 9 例原發性甲狀腺淋巴瘤的診治分析[J]. 診斷學理論與實踐, 2025, 24(6): 634-640.
- 24. Ota H, Ito Y, Matsuzuka F, et al. Usefulness of ultrasonography for diagnosis of malignant lymphoma of the thyroid[J]. Thyroid, 2006, 16(10): 983-987.
- 25. Xia Y, Wang L, Jiang Y, et al. Sonographic appearance of primary thyroid lymphoma-preliminary experience[J]. PLoS One, 2014, 9(12): e114080.
- 26. He X, Bai Y, Wang S, et al. Ultrasonographic differentiation of diffuse large B-cell lymphoma and mucosa-associated lymphoid tissue lymphoma in primary thyroid lymphoma[J]. Front Endocrinol (Lausanne), 2026, 17: 1743975.
- 27. Chen J, Deng Z, Chen Y, et al. Deep learning based on B-mode and color Doppler ultrasound for differentiation of primary thyroid lymphoma and Hashimoto’s thyroiditis: a retrospective single-center study[J]. Diagnostics (Basel), 2026, 16(12): 1909.
- 28. 趙玲, 商雷, 何岸柳, 等. 超聲對原發性甲狀腺淋巴瘤與甲狀腺未分化癌的鑒別診斷[J/OL]. 中華醫學超聲雜志(電子版), 2021, 18(1): 17-24. DOI: 10.3877/cma.j.issn.1672-6448.2021.01.005.
- 29. 張盼, 李陽, 鹿麟, 等. 原發性甲狀腺淋巴瘤的超聲表現[J]. 中國超聲醫學雜志, 2018, 34(7): 668-670.
- 30. Yang L, Zhao H, He Y, et al. Contrast-enhanced ultrasound in the differential diagnosis of primary thyroid lymphoma and nodular Hashimoto’s thyroiditis in a background of heterogeneous parenchyma[J]. Front Oncol, 2021, 10: 597975.
- 31. 彭嬋娟, 孔祥凱, 吳軍舟, 等. 超聲分型對原發性甲狀腺淋巴瘤的診斷價值[J/OL]. 中華醫學超聲雜志(電子版), 2022, 19(5): 447-453. DOI: 10.3877/cma.j.issn.1672-6448.2022.05.010.
- 32. Xu R, He Y, Xie X, et al. Diagnostic value of contrast-enhanced ultrasound for differentiating benign and malignant thyroid nodules: a systematic review and meta-analysis[J]. Ultrasound Med Biol, 2025, 51(11): 1878-1887.
- 33. Wei X, Li Y, Zhang S, et al. Evaluation of primary thyroid lymphoma by ultrasonography combined with contrast-enhanced ultrasonography: a pilot study[J]. Indian J Cancer, 2015, 52(4): 546-550.
- 34. 趙佳琦, 刁宗平, 章建全, 等. 原發性甲狀腺淋巴瘤多種模式超聲表現特征[J/OL]. 中華醫學超聲雜志(電子版), 2017, 14(9): 701-705. DOI: 10.3877/cma.j.issn.1672-6448.2017.09.014.
- 35. Chang D, Wang Q. Diagnostic value of ultrasound elastography and conventional ultrasound for thyroid nodules: a meta-analysis[J]. Quant Imaging Med Surg, 2023, 13(3): 1300-1311.
- 36. Dragota RS, Popescu M, Rogoveanu I, et al. The utility of shear wave elastography in Hashimoto disease: a systematic review and meta-analysis[J]. Ultrasound Med Biol, 2026, 52(1): 41-51.
- 37. Yildirim D, Gurses B, Gurpinar B, et al. Nodule or pseudonodule? Differentiation in Hashimoto’s thyroiditis with sonoelastography[J]. J Int Med Res, 2011, 39(6): 2360-2369.
- 38. Yang W, Zhou J, Yue C, et al. Clinical value of contrast-enhanced ultrasound quantitative analysis for differentiating thyroid lesions in Hashimoto’s thyroiditis patients[J]. Quant Imaging Med Surg, 2024, 14(1): 944-957.
- 39. Tessler FN, Middleton WD, Grant EG, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): white paper of the ACR TI-RADS Committee[J]. J Am Coll Radiol, 2017, 14(5): 587-595.
- 40. Pan FS, Wang W, Wang Y, et al. Sonographic features of thyroid nodules that may help distinguish clinically atypical subacute thyroiditis from thyroid malignancy[J]. J Ultrasound Med, 2015, 34(4): 689-696.
- 41. Ruchala M, Szczepanek-Parulska E, Zybek A, et al. The role of sonoelastography in acute, subacute and chronic thyroiditis: a novel application of the method[J]. Eur J Endocrinol, 2012, 166(3): 425-432.
- 42. Zhang Q, Liao L, Peng Q, et al. Value of contrast-enhanced ultrasound in differentiating clinically atypical subacute thyroiditis from papillary thyroid carcinomas[J]. Ultrasound Med Biol, 2021, 47(12): 3384-3392.
- 43. 周瑞莉, 郭玉萍, 黃春旺. 原發性甲狀腺淋巴瘤的超聲診斷: 漏診和誤診分析[J]. 循證醫學, 2025, 25(2): 99-104.
- 44. 中華醫學會超聲醫學分會淺表器官和血管學組, 中國甲狀腺與乳腺超聲人工智能聯盟. 2020 甲狀腺結節超聲惡性危險分層中國指南: C-TIRADS[J]. 中華超聲影像學雜志, 2021, 30(3): 185-200.
- 45. Lee JS, Shin S, Yun HJ, et al. Primary thyroid lymphoma: a single-center experience[J]. Front Endocrinol (Lausanne), 2023, 14: 1064050.
- 46. Hirokawa M, Kudo T, Ota H, et al. Preoperative diagnostic algorithm of primary thyroid lymphoma using ultrasound, aspiration cytology, and flow cytometry[J]. Endocr J, 2017, 64(9): 859-865.
- 47. Chen C, Huang T, Tuan Y, et al. Surgeon-performed point-of-care ultrasound and ultrasound-guided core biopsy reduce diagnostic invasiveness in primary thyroid lymphoma[J]. Eur Arch Otorhinolaryngol, 2025, 282(10): 5323-5331.
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