ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Ultrasonographic Differentiation of Diffuse Large B‑Cell Lymphoma (DLBCL) and Mucosa‑Associated Lymphoid Tissue (MALT) Lymphoma in Primary Thyroid Lymphoma
Provisionally accepted
Xining He1,2,3,4
Ying Bai2,3,4
Qianyuan Chen5
Haiyan Cao2,3,4
Peipei Xu2,3,4
Mengyun Yao2,3,4
Wenjing Zhang2,3,4
Zhen Wang2,3,4
Xiuhua Wang2,3,4
Jiajia Xiong2,3,4
Feixiang Xiang2,3,4*Cheng Yu2,3,4*
Jiawei Shi2,3,4*- 1Chongqing Hospital, Union Hospital,Tongji Medical College, Huazhong University of Science and Technology, Chongqing, China
- 2Department of Ultrasound Medicine, Huazhong University of Science and Technology Tongji Medical College Union Hospital, Wuhan, China
- 3Hubei Province Clinical Research Center for Medical Imaging, Wuhan, China
- 4Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
- 5Department of Pathology, Huazhong University of Science and Technology Tongji Medical College Union Hospital, Wuhan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Purpose: The aim of this study was to evaluate the ultrasonographic differences between diffuse large B-cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue (MALT) lymphoma in primary thyroid lymphoma (PTL). Methods: A total of 46 patients with histopathologically confirmed PTL (27 with DLBCL and 19 with MALT lymphoma) were included in this study. All patients underwent ultrasonographic imaging prior to initiation of therapy. We retrospectively reviewed all images and compared the imaging findings between the two pathologies. Results: DLBCL was more likely to demonstrate greater clinical aggressiveness than MALT lymphoma, as indicated by a significantly higher rate of perithyroidal tissue invasion (41% vs. 11%, P = 0.025) and a lower proportion of asymptomatic cases (19% vs. 47%, P = 0.036). The percentage of participants with lesions showing markedly hypoechoic echogenicity on ultrasound was 52% (14 of 27) in DLBCL group, compared with 5% (1 of 19) in MALT group (P = 0.001). Additionally, the mean maximum diameter of lesions was 62.5 ± 29.6 mm in DLBCL versus 38.1 ± 21.7 mm in MALT lymphoma (P = 0.004). Multivariable analysis showed that only hypoechoic lesions were independently associated with DLBCL (odds ratio 0.08; 95% CI 0.01–0.82). Conclusions: DLBCL is frequently characterized by markedly hypoechoic echogenicity, larger lesion size, and perithyroidal invasion on ultrasonography, whereas MALT lymphoma commonly presents with asymptomatic clinical manifestations.
Keywords: differential diagnosis, diffuse large B cell lymphoma, Mucosa-associated lymphoid tissue lymphoma, Primary thyroid lymphoma, Ultrasonography
Received: 11 Nov 2025; Accepted: 23 Jan 2026.
Copyright: © 2026 He, Bai, Chen, Cao, Xu, Yao, Zhang, Wang, Wang, Xiong, Xiang, Yu and Shi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Feixiang Xiang
Cheng Yu
Jiawei Shi
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.