The Role of Ultrasonography in Monitoring Chemotherapeutic Effects for Primary Thyroid Lymphoma: A Single-center Retrospective Study

Abstract Background: This study aimed to assess the utility of ultrasonography in monitoring the chemotherapeutic effects in primary thyroid lymphoma (PTL). Methods: This retrospective analysis included 17 patients with PTL who underwent chemotherapy from 2012–2022 (>10 years). Sonographic features were examined pre- and post-treatment using ultrasound to monitor treatment response at 2, 4, and end cycles of chemotherapy along with follow-up. Progression-free survival (PFS) and overall survival (OS) were analyzed. Results: Sonographic findings in all patients indicated diffuse or nodular infiltration with markedly hypoechoic masses. “Strip-shaped” high echoes and posterior acoustic enhancement were observed. In the diffuse group, complete response (CR) rates were 0%, 80%, and 80%, while partial response (PR) rates were 100%, 20%, and 0% at 2, 4, and end cycles post-chemotherapy, respectively. For the nodular group, CR rates were 0%, 20%, and 66.7%, with PR rates of 86.7%, 53.3%, and 13.3% at the same corresponding time points. After the end cycle of chemotherapy, the lesion sizes had significantly decreased compared to baseline (p <0.05). Post-chemotherapy, Adler’s blood flow grades decreased significantly, with 80% graded as 0–1. Among the 10 patients with cervical lymph node enlargement, 70% showed reduced lesion sizes and blood flow signals. The cumulative 5-year PFS and OS rates were 80% and 80% for the diffuse type, and 82.5% and 78.8% for the nodular type, respectively (p >0.05). Conclusions: Ultrasound examination can be used to monitor PTL treatment response post-chemotherapy, especially for efficacy evaluation after 2 cycles. Trial registration: retrospectively registered