目的： 分析总结原发性甲状腺淋巴瘤（primary thyroid lymphoma，PTL）患者的临床及超声影像学特征、诊断及治疗经验。方法： 2022年10月至2024年12月期间，收集上海交通大学医学院附属第六人民医院收治的经病理活检证实为PTL的9例连续病例，回顾性分析其临床资料、超声特征、病理诊断方式及诊治经过。结果： 9例患者中，女性7例，男性2例，中位年龄76岁（39~88岁）。所有患者均因颈部进行性增大肿块就诊，6例伴梗阻症状，8例合并桥本甲状腺炎（Hashimoto’s thyroiditis， HT）。超声分型为弥漫型2例（受累叶弥漫性增大，呈现低回声伴内部线状回声，后方回声增强），结节型3例（单发低回声结节），混合型4例（腺体肿大，伴多发低回声区）。病理诊断方式中，5例经细针穿刺抽吸（fine needle aspiration， FNA）联合空芯针活检（core needle biopsy， CNB）确诊；2例经CNB直接确诊；2例经手术病理确诊。所有患者初始均接受免疫化疗（R-CHOP/miniCHOP或Pola-R-miniCHP±Glofit，6~8个疗程），3例未达完全缓解者后续联合受累区域放疗。7例可评估患者中，完全缓解4例，部分缓解2例，1例部分缓解后进展死亡。结论： 老年HT患者出现短期内甲状腺肿块迅速增大伴梗阻症状时，需警惕PTL。PTL特征性超声表现为弥漫性和（或）结节性的低或极低回声病灶，伴内部线状高回声、后方回声增强、丰富血流及无钙化。临床疑诊PTL时，推荐优先采用CNB细胞学检查，以提高诊断准确率。以免疫化疗为主，或联合放疗的综合治疗，可获良好预后。

Objective To analyze and summarize the clinical and ultrasonographic features, as well as the diagnostic and therapeutic experiences, of patients with primary thyroid lymphoma (PTL). Methods A total of 9 consecutive cases of PTL, confirmed by pathological biopsy and admitted to Shanghai Sixth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine from October 2022 to December 2024, were collected. A retrospective analysis was conducted on their clinical data, ultrasonographic characteristics, pathological diagnostic methods, and diagnosis and treatment process. Results Among the 9 patients (7 females, 2 males), the median age was 76 years (range: 39-88 years). All patients presented with progressively enlarging neck masses, six cases had obstructive symptoms, and eight cases were complicated with Hashimoto's thyroiditis (HT). Ultrasonography classified cases as: diffuse type (n=2, diffusely enlarged involved lobe with hypoechogenicity, internal linear echoes, and posterior acoustic enhancement), nodular type (n=3, solitary hypoechoic nodules), and mixed type (n=4, glandular enlargement with multifocal hypoechoic lesions). Regarding pathological diagnosis methods, 5 cases were confirmed by fine needle aspiration (FNA) combined with core needle biopsy (CNB), 2 cases were directly diagnosed by CNB, and 2 cases were diagnosed by surgical pathology. All patients initially received immunochemotherapy (R-CHOP/miniCHOP or Pola-R-miniCHP ± Glofit, 6-8 cycles). Three patients with incomplete remission received subsequent involved-site radiotherapy. Among 7 evaluable patients, 4 achieved complete remission (CR), 2 had partial remission (PR), and 1 died of progression after PR. Conclusions When elderly HT patients pre-sent with rapidly enlarged thyroid mass and obstructive symptoms over a short period, the possibility of PTL should be suspected. Characteristic ultrasonographic features include diffuse/nodular hypo-/marked hypoechoic lesions with internal linear hyperechoic strands, posterior acoustic enhancement, abundant vascularity, and absence of calcification. When PTL is clinically suspected, CNB cytology examination is recommended as the preferred method to improve diagnostic accuracy. Comprehensive treatment based on immunochemotherapy with or without radiotherapy can provide a favorable prognosis.