open access

Vol 70, No 6 (2019)
Original paper
Published online: 2019-09-17
Submitted: 2019-04-16
Accepted: 2019-06-23
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Is ultrasound combined with computed tomography useful for distinguishing between primary thyroid lymphoma and Hashimoto’s thyroiditis?

Jieli Luo, Fengbo Huang, Panpan Zhou, Jianshe Chen, Yang Sun, Fangting Xu, Lilu Wu, Pintong Huang
DOI: 10.5603/EP.a2019.0036
·
Pubmed: 31529457
·
Endokrynologia Polska 2019;70(6):463-468.

open access

Vol 70, No 6 (2019)
Original Paper
Published online: 2019-09-17
Submitted: 2019-04-16
Accepted: 2019-06-23

Abstract

Introduction: The aim of the study is to investigate the usefulness of ultrasound combined with computed tomography (CT) for distinguishing between primary thyroid lymphoma (PTL) and Hashimoto’s thyroiditis (HT). Material and methods: The investigation was conducted retrospectively in 80 patients from January 2000 to July 2018. All patients underwent pathological tests to be classified into one of two groups: PTL group and HT group. The cut-off value of CT density was determined using receiver-operating characteristic (ROC) curve analysis. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of diagnosis for thyroid by CT alone, ultrasound alone, and the combination of CT plus ultrasound were calculated. Results: Of the 80 study patients, 27 patients were PTL and 53 patients were HT. Mean CT density had a sensitivity of 90.6% and a specificity of 88.9% at a cut-off value of 53.5 HU, with area under the curve (AUC) 0.88. Ultrasound combined with CT had the highest specificity, accuracy, and PPV compared with CT alone and ultrasound alone (p value < 0.05). Conclusions: Features such as extremely hypoechogenicity, enhanced posterior echo, cervical lymphadenopathy in ultrasound image, and linear high-density strand signs, and very low density in CT imaging have high sensitivity and specificity in thyroid lymphoma. Therefore, ultrasound combined with CT may be useful for distinguishing between PTL and HT. 

Abstract

Introduction: The aim of the study is to investigate the usefulness of ultrasound combined with computed tomography (CT) for distinguishing between primary thyroid lymphoma (PTL) and Hashimoto’s thyroiditis (HT). Material and methods: The investigation was conducted retrospectively in 80 patients from January 2000 to July 2018. All patients underwent pathological tests to be classified into one of two groups: PTL group and HT group. The cut-off value of CT density was determined using receiver-operating characteristic (ROC) curve analysis. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of diagnosis for thyroid by CT alone, ultrasound alone, and the combination of CT plus ultrasound were calculated. Results: Of the 80 study patients, 27 patients were PTL and 53 patients were HT. Mean CT density had a sensitivity of 90.6% and a specificity of 88.9% at a cut-off value of 53.5 HU, with area under the curve (AUC) 0.88. Ultrasound combined with CT had the highest specificity, accuracy, and PPV compared with CT alone and ultrasound alone (p value < 0.05). Conclusions: Features such as extremely hypoechogenicity, enhanced posterior echo, cervical lymphadenopathy in ultrasound image, and linear high-density strand signs, and very low density in CT imaging have high sensitivity and specificity in thyroid lymphoma. Therefore, ultrasound combined with CT may be useful for distinguishing between PTL and HT. 

Get Citation

Keywords

primary thyroid lymphoma; Hashimoto’s thyroiditis; computed tomography density; ultrasound; receiver operating characteristic

About this article
Title

Is ultrasound combined with computed tomography useful for distinguishing between primary thyroid lymphoma and Hashimoto’s thyroiditis?

Journal

Endokrynologia Polska

Issue

Vol 70, No 6 (2019)

Article type

Original paper

Pages

463-468

Published online

2019-09-17

DOI

10.5603/EP.a2019.0036

Pubmed

31529457

Bibliographic record

Endokrynologia Polska 2019;70(6):463-468.

Keywords

primary thyroid lymphoma
Hashimoto’s thyroiditis
computed tomography density
ultrasound
receiver operating characteristic

Authors

Jieli Luo
Fengbo Huang
Panpan Zhou
Jianshe Chen
Yang Sun
Fangting Xu
Lilu Wu
Pintong Huang

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