PRIMARY THYROID LYMPHOMA - EVALUATION WITH US, CT, AND MRI

Objective: Our goal was to determine the most effective radiologic wor kup in diagnosing and staging primary thyroid lymphomas and the value of knowing the extent of tumors for prognostic purposes. Materials and Methods: Magnetic resonance imaging, CT, US, and fine-needle aspirati on (FNA) biopsy (palpation- or US-guided) findings were retrospectivel y reviewed in 14 patients with primary thyroid lymphomas (5 palpable, 9 nonpalpable). Survival was correlated with the presence or absence o f extrathyroidal spread of lymphoma. Results: Thyroid lymphomas were d etected in all patients with US and 12 (86%) each with CT and MRI. His topathologic diagnosis was obtained with FNA in 11 patients (79%) and with surgical procedures in 3. Magnetic resonance imaging correctly di agnosed tumor involvement of the lymph nodes (four of four patients), muscle (five of five), esophagus (one of one), internal jugular vein ( one of one), and carotid artery (one of one). Muscle invasion was miss ed with CT in one patient. Ultrasound was not accurate for diagnosing tumor invasion of the esophagus, carotid artery, and lymph nodes. The survival of patients without extrathyroidal spread was significantly ( p < 0.05) better than that of patients (n = 5) with extrathyroidal spr ead. Conclusion: Palpable thyroid masses should undergo palpation-guid ed FNA for diagnosis and nonpalpable masses US-guided FNA. Tumor exten t and staging should be determined with MRI, which will contribute to initiating appropriate therapy and prediction of prognosis.