Lymphoma is a common hematological malignancy with markedly increasing incidence. Its pathological types are complex and heterogeneous, and there are significant differences in treatment options and efficacy. Therefore, early and precise diagnosis, assessment of efficacy, and judgment of prognosis are key clinical problems. Ultrasound (US) has important clinical value in the diagnosis and treatment of lymphoma. This article reviews the progress made with new US technologies in improving the accuracy of diagnosis and staging of lymphoma, predicting the course of lymphoma, monitoring the progression of lesions during treatment, and assisting clinics in formulating accurate and effective treatment plans. In addition, we review the biological basis of US prediction of lymphoma and provide an outlook for future research directions.

Thyroid metastatic tumors are a series of rare clinical disease with an incidence of approximately 1.4-3%, of which metastatic tumor from the digestive system is even rarer. Thyroid metastatic tumor from the digestive system is characterized by a rapid growth tumor with high invasiveness and poor prognosis. Ultrasound (US) and contrast-enhanced ultrasound (CEUS) could provide more information for making diagnosis, determining lesion range, and offering biopsy guidance. Ultrasound-guided core needle biopsy (CNB) should be used instead of fine needle aspiration (FNA) to confirm the pathological diagnosis. Here, we report two cases of thyroid metastatic tumor from the digestive system. By describing these cases, we aimed to assess the clinical value of conventional US and CEUS in the diagnosis and treatment of these tumors.

Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare clinical disease characterized by rapid growth, high invasiveness, and a poor prognosis. A 66-year-old male patient was admitted due to throat pain and dysphagia. Ultrasound revealed a calcified hypoechoic mass in the right lobe of the thyroid gland, measuring approximately 35.3 ml. Ultrasound and PET-CT both indicated high suspicion of malignancy. The patient underwent contrast-enhanced US-guided biopsy, and the pathological results revealed poorly differentiated squamous cell carcinoma. CEUS was performed regularly during the Chemotherapy combined with pembrolizumab (PD-1) treatment courses. The vital area was significantly reduced with neither recurrence nor cervical lymph node metastasis. Surgical resection and chemotherapy combined with immunotherapy had a significant treatment effect in this case. CEUS is helpful for diagnosis confirmation, biopsy guidance and efficacy evaluation and has important clinical application value.

Percutaneous endoscopic lumbar discectomy (PELD) has become a mature and mainstream minimal invasive surgical technique in the treatment of lumbar disc herniation (LDH). During the operation, transforaminal puncture is considered as a critical and complicated step which is usually carried out under the guidance of X-ray. However, radiation exposure brings a potential threat to the health of the patients and the surgeons. Besides, nerve roots and vessels may be injured since they are invisible on X-ray. So we still need a real-time accurate image guiding system, especially in difficult cases with anatomic variation. Here we report a case to describe a new method, volume navigation with fusion of real-time ultrasound and CT images, to guide PELD in a patient with right L4-L5 LDH who had anatomic variation of lumbar sacralization. Ultrasound volume navigation guided puncture and cannulation process lasted only 10 minutes and the operation decompression time lasted 60 minutes. The total emission radiation dose was 9mGy. The straight leg elevation increased from 50 to 80 degrees after PELD. The Visual Analog Scale (VAS) of low back pain reduced from 5 to 1 and leg pain reduced from 7 to 1 immediately after PELD. This is the first case of ultrasound volume navigation in guidance of the postural lateral transforaminal puncture and cannulation process of PELD.