Approach to primary thyroid lymphoma: case series

Abstract

Primary thyroid lymphomas are rare thyroid neoplasms. Mucosa Associated Lymphoid tissue (MALT) lymphoma and diffuse large B-cell Non-Hodgkin lymphoma are the most common types. It is more common in the elderly, and especially in women. Patients usually present with a rapidly growing mass in the neck. This article aimed to present the epidemiological features, treatment and prognostic factors of thyroid lymphomas by retrospectively reviewing 4 patients with thyroid lymphoma. Four patients were treated for primary thyroid lymphoma, two of whom were women and two were men, with a mean age of 63.7 (51-74) years. Common complaint of those patients was the sudden swelling of the neck. Two patients were diagnosed with fine needle aspiration biopsy (FNAB) and the other two patients were diagnosed with surgical excision. Chemotherapy and radiotherapy were applied to all four patients. While one patient died in the second year of follow-up, the other three patients are still being followed. Primary thyroid lymphomas are not aggressive tumors, and the most effective treatment is radiotherapy.

Differential diagnosis of non-diffuse primary thyroid lymphoma and papillary thyroid carcinoma by ultrasound combined with computed tomography

“…This study retrospectively reviewed the clinical and imaging features of 50 non-diffuse PTL patients and 100 PTC patients, and found that there was no significant difference in gender ratio between patients with non-diffuse PTL and PTC, both occurring commonly in the female. Comparatively, non-diffuse PTL (aged 63.06 ± 10.14 years) was greater than PTC (aged 41.63 ± 15.06 years) in the age of onset (63.06 ± 10.14 years old) with a statistical significance (P < 0.001), which is similar to the prior reports by Acar et al [3] and Ota et al [31], and was also higher than PTC in the incidence with asymmetric enlargement and HT. Studies have shown that most PTL originate in the setting of HT, with which the patients carry a 40-80 folds higher risk of thyroid lymphoma than the healthy population, and HT is the recognized risk factor for PTL [5,32].…”

“…PTL is usually characterized as B-cell-derived Non-Hodgkin lymphoma, the most common types of which include diffuse large B cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue lymphoma (MALT). This disease is closely associated with Hashimoto thyroiditis (HT) and develops in the setting of chronic thyroiditis [3][4][5]. The diagnosis of HT is debated and is traditionally considered histological [6,7].…”

Primary thyroid lymphoma with double expression of MYC and B-cell lymphoma-2 Gene

“…Acar et al reported a case series in 2019 in which four patients were treated for primary thyroid lymphoma; two of which were DLBCL, one was MALT and one was HGL. The HGL on further pathological evaluation tested negative for BCL-2 and BCL-6, further reinforcing the status of double expression lymphomas being the rarest of entities [7].…”

A diffuse large B‐cell thyroid lymphoma presented as a compressive goiter in a young woman with no evidence of Hashimoto's thyroiditis

“…In 50%–90% of cases, the diagnosis is made by fine‐needle aspiration cytology. 15 , 24 Similarities may be observed between thyroid lymphoma, Hashimoto's thyroiditis, anaplastic carcinoma, and Riedel's thyroiditis which represent the principal differential diagnosis on cytology. Therefore, lobectomy and core biopsy are the preferred diagnostic approaches.…”