Clinicopathological features of 171 cases of primary thyroid lymphoma: a long‐term study involving 24 553 patients with Hashimoto’s disease

Abstract

Summary There are few large‐scale reports of primary thyroid lymphoma (PTL). This study clinically and pathologically reviewed 171 patients with PTL and 24 553 patients with Hashimoto’s disease at Ito Hospital between January 1990 and December 2004, to investigate the clinical features and the treatment outcomes of PTL. The median age of the patients with PTL was 67 years (range, 27–90 years). The pathological diagnosis of PTL patients included diffuse large B‐cell lymphoma (DLBCL) (n = 74), DLBCL with mucosa‐associated lymphoid tissue (MALT) lymphoma (n = 13), MALT lymphoma (n = 80) and others (n = 4). Of the 167 patients with B‐cell lymphoma, treatment included combined modality therapy (CMT) (n = 95), radiation therapy (RT) alone (n = 60) and chemotherapy alone (n = 6). Information on treatment was not available in six patients. Information on treatment response was available in 154 patients; 149 patients (97%) responded to treatment. According to the institutional treatment strategy of Ito Hospital, 45 of 54 patients with stage IE disease received RT alone, and 87 of 113 stage IIE patients received CMT. The 5‐year overall survival rate was 85% (95% confidence interval, 79–91%). This study demonstrated that PTL showed good response to radiotherapy and chemotherapy and had a favourable prognosis.

T-cell Lymphoma of Thyroid Gland with Lennert Type of Morphology: A Case Report and Review of the Literature

“…However, the majority of the cases of thyroid TCL also had a history of Hashimoto's thyroiditis much like B-cell lymphomas where it is an almost universal finding [2,7,8]. This patient also had an antecedent history of Hashimoto's thyroiditis of 2 years duration before the diagnosis of TCL of thyroid.…”

“…B-cell lymphomas overwhelmingly outnumber their T-cell counterparts in thyroid gland, with only about twenty cases of TCL having been reported in the literature [2][3][4][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The first case of TCL of thyroid was reported in an English lady in 1977 [12].…”

“…Almost four decades later the repertoire of such cases has increased to a modest total of just about 20, underlying the rarity of their occurrence. Watanabe et al [2] found a single case of T-cell phenotype in a large study from Japan comprising of 171 cases of primary thyroid lymphomas diagnosed in a large cohort of 24,553 patients of Hashimoto's thyroiditis. Geographical differences in incidence of cases of thyroid TCL, if any, are difficult to establish because of the obvious limitation of the number of cases.…”

“…Primary lymphoma of the thyroid is a rare neoplasm comprising 2-5 % of all thyroid malignancies [1][2][3]. Almost all primary thyroid lymphomas turn out to be a non-Hodgkin lymphoma (NHL) of B-cell origin of either marginal zone lymphoma of mucosa associated lymphoid tissue (MALT) or diffuse large B-cell lymphoma (DLBCL) type [2][3][4][5].…”

“…Almost all primary thyroid lymphomas turn out to be a non-Hodgkin lymphoma (NHL) of B-cell origin of either marginal zone lymphoma of mucosa associated lymphoid tissue (MALT) or diffuse large B-cell lymphoma (DLBCL) type [2][3][4][5]. T-cell lymphoma (TCL) in the thyroid gland is distinctly rare with about 20 cases having been reported so far in the literature [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”