To investigate the ultrasonographic features of thyroid lymphoma and its different pathological types.

The clinical manifestations and sonographic findings were analyzed retrospectively in 30 patients with pathological confirmed thyroid lymphoma from January 2014 to November 2019 in Ruijin Hospital Affiliated to the Shanghai Jiao Tong University of Medicine. Ultrasonographic features of different pathological types of thyroid lymphoma were compared.

There were 30 patients included in the study. All the lesions were pathologically diagnosed as diffuse large B-cell lymphoma(17/30, 56.7%), mucosa-associated lymphoma(8/30, 26.7%), follicular lymphoma(3/30, 10.0%), gray zone lymphoma(1/30, 3.3%), and lymphoblastic lymphoma(1/30, 3.3%). Clinical features included short-term neck enlargement (60.0%), with compression symptoms (46.7%), Ⅲ/Ⅳ cervical region lymphadenopathy (63.3%), thyroid dysfunction (10.0%), combined with Hashimoto′s thyroiditis (63.3%). Statistical differences were found in the longitudinal diameter of the lesion (P=0.036), ultrasonographic features (P=0.036), and the margin of the lesion (P=0.005) between diffuse large B-cell lymphoma and mucosa-associated lymphoid tissue lymphoma.Ultrasonographic features (P=0.005) and lesion edges (P=0.020) differed significantly between different aggressiveness.

Patients with Hashimoto′s who have noticed a short-term enlargement of extremely low echogenic mass in the thyroid gland and lymphadenopathy in the neck Ⅲ/Ⅳ region should be suspected of having thyroid lymphoma. Very low echo lesions with irregular edges and flaky hyperechoes are characteristic features of diffuse large B cell lymphoma, and very low echo lesions with rims and grid echoes are characteristics of mucosa-associated lymphoma.

Ultrasonography; Thyroid; Lymphoma; Pathology