Photo Credit: Dr. Microbe
The following is a summary of “Potential Value of Ultrasound in Predicting Local Refractory/Relapse Events in Primary Thyroid Lymphoma Patients,” published in the March 2024 issue of Oncology by Ji et al.
Primary thyroid lymphoma (PTL) represents a rare yet clinically significant malignancy, wherein ultrasound emerges as a pivotal tool for both diagnosis and ongoing surveillance. Despite the essentiality of predicting refractory or relapse events in patients with PTL, ultrasonic features correlating with such outcomes still need to be identified. In this study, encompassing the period from January 2008 to September 2022, researchers enrolled newly diagnosed patients with PTL undergoing standard first-line treatment, all of whom underwent pre-treatment ultrasound examinations.
Comprehensive data encompassing clinical profiles, sonographic features, and therapeutic responses were meticulously collected. Of the 37 patients with PTL analyzed, comprising predominantly diffuse large B-cell lymphoma cases alongside a minority with follicular or mucosa-associated lymphoid tissue lymphoma, a median follow-up of 25 months revealed varied therapeutic responses, with 30 patients achieving complete remission, while 4 were refractory and 3 experienced local relapses. While baseline clinical characteristics failed to exhibit significant disparities between patients with favorable prognoses and those facing refractory or relapse events, sonographic evaluations unveiled compelling insights. Notably, an analysis of event-free survival (EFS) curves underscored that patients manifesting bilobar enlargement (defined as an anterior-posterior diameter exceeding 2.5 cm on both thyroid lobes) exhibited significantly poorer EFS compared to counterparts without such enlargement (P < 0.0001).
Similarly, patients exhibiting a diffuse ultrasound pattern demonstrated inferior EFS compared to those with mixed or nodular patterns (P = 0.043). Conversely, no discernible discrepancy in EFS emerged concerning indicators such as suspicious cervical lymph node metastasis, abundant blood signal distribution, or symptoms indicative of tracheal compression. In summation, their findings illuminate the potential of specific ultrasonic parameters, notably bilobar enlargement, and the diffuse ultrasound pattern, as prognostic indicators predisposing patients with PTLs to be refractory or local relapse events, thereby enriching the understanding and clinical management strategies in this rare yet consequential malignancy.
Source: cancerimagingjournal.biomedcentral.com/articles/10.1186/s40644-024-00681-z
