Management for primary thyroid lymphoma: Experience from a single tertiary care centre in Taiwan

Wu, Seng-Tang; Chu, Chin-Chen; Duh, Quan‐Yang; Hsieh, Chung-Bao; Yu, Jyh‐Cherng; Shih, Ming-Lang

doi:10.1016/j.fjs.2016.07.001

Cited by 6 publications

(16 citation statements)

References 31 publications

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“…PTNHL of the thyroid gland often affects elderly women (1,5,8,9) aged between 50-80 years and less often younger people aged 40 years (2,3,10) , with typically a history of lymphocytic thyroiditis (4,9,11) . In our study, (12) .…”

Section: Discussionmentioning

confidence: 99%

“…In the case of lymphoma, this lymphoid tissue appears in the condition of chronic inflammation which is a response to infection conditions or autoimmune process (11) . Links among auto-immune disease, chronic antigenic stimulation, and PTL have been demonstrated, and Hashimoto's thyroiditis represents the major risk factor (1,12,14) especially in a delay of 20-30 years after initial diagnosis (5,7,10,12) . Commonly, Hashimoto's thyroiditis is considering as a causal factor of primary thyroid MALT lymphoma, which itself may evolve into aggressive lymphoma (6,12,14,15) , by activating B-cells to secrete antibodies, conducting to hyperplasia or malignant transformation of lymphoid tissue (4) .…”

Section: Discussionmentioning

confidence: 99%

“…Concerning our patients, we didn't notice any antecedent of Hashimot's thyroiditis, but we suggest a pre-existing chronic thyroiditis within 3 patients having a biologic hypothyroidism. The most common clinical presentation is an enlarging painless neck mass, growing rapidly between 1 and 3 months at about 70% of cases (5,7,15) and causing an obstruction of the upper airway tract in an approximately 30% of cases (12) , most often we notice a dysphagia, dyspnea, rarely it's about stridor, hoarseness, dysphonia, or vena cava obstruction (11,12,13,14,16) . In our cases, the prevalent clinical presentation was a rapid enlarging goiter causing an obstruction of the upper airway revealing by dysphonia (paralysis of vocal cord) in one case of DLBCL, and dyspnea in another two cases ; first one was about a women aged 81 years consulting with dyspnea requiring an urgent intervention of desobstruction by tracheotomy, it was a DLBCL ; and for the second case we practice a CT that objective a huge goiter associated to a bilateral lymph nodes, there were a resolution of dyspnea after treatment by corticoids and chemotherapie, it was a rare case of MCL (mantle cell lymphoma).…”

Section: Discussionmentioning

confidence: 99%

“…Often patients are in clinical and biological euthyroid, contrary to what we conclude with our study population, in whom 3 cases wherein hypothyroid situation. Microscopically, large cell lymphoma is observed as atypical large lymphocytes with frequent mitosis and reveal positive cell markers CD20 and CD 79 on immunohistochemical staining (5) . While MALT lymphoma is composed of small to intermediate sized lymphocytes with slight nuclear irregularity and pale cytoplasm imparting a monocytoid or plasmacytoid appearance (9) .…”

Section: Discussionmentioning

confidence: 99%

“…Primary thyroid non Hodgkin's lymphoma (PT-NHL), which defined as a lymphoma occurring in the thyroid gland with or without the involvement of regional lymph nodes, is a quite rare pathologic entity, accounting for 1,3-1,5 % of thyroid neoplasm, and 0,5% of lymphoma (4) . We describe different subtypes of NHL which are classified according to histological and immunological features, having different natural histories, and therapeutic responses (3,5) . Diffuse large B-cell lymphoma is the predominant subtype accounting 50% to 68% of PTL, followed by the extranodal marginal zone B-cell lymphoma of MALT which occurring in 23% of PTL, and less common mantle cell lymphoma, SLL, and follicular lymphoma (1,2,4,6,7) .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Primary Thyroid Lymphoma : An Uncommon Etiology of Compressive Goiter

Meherzi¹,

Bellakhdher²,

Khaireddine³

et al. 2017

IAM

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Primary thyroid non-Hodgkin's lymphoma is a rare entity. It is defined as a lymphoma occurring in the thyroid gland with or without the involvement of regional lymph nodes. Diffuse large B-cell lymphoma is the predominant subtype, followed by the extranodal marginal zone B-cell lymphoma of MALT, mantle cell lymphoma, SLL, and follicular lymphoma. Hashimoto's thyroiditis is considering as a causal factor. Diffuse large B-cell lymphoma and mantle cell lymphoma are known by an aggressive course while MALT lymphoma and small lymphocytic lymphoma (SLL) are characterized by an indolent clinical course. The most common clinical presentation is an enlarging painless neck mass, growing rapidly and causing an obstruction of the upper airway. Differential diagnosis is an anaplastic carcinoma, squamous cell carcinoma, metastasis of unknown primary and thyroiditis. The sensitivity and the specificity of the FNAC can be increased if consolidated by the use of the flow cytometry, the immunohistochemistry (IHC) and PCR.Three modalities of treatment could be proposed: surgery, radiotherapy, and chemotherapy-dependent on the histologic subtype.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Primary Thyroid Lymphoma : An Uncommon Etiology of Compressive Goiter

Meherzi¹,

Bellakhdher²,

Khaireddine³

et al. 2017

IAM

View full text Add to dashboard Cite

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The diagnosis of primary thyroid lymphoma by fine‐needle aspiration, cell block, and immunohistochemistry technique

Huang

Li²,

Wang

et al. 2020

Diagnostic Cytopathology

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Aim: Primary thyroid lymphoma (PTL) is a rare malignant disease. Its prognosis depends on early diagnosis. The role of fine-needle aspiration (FNA), including smear cytology, cell block (CB) techniques, and immunohistochemistry (IHC) sections in the diagnosis of PTL is still unclear. Here we reported 19 cases of PTL and literature review to evaluate the diagnostic accuracy for lymphoma by cytology. Methods: Our study retrospectively reviewed 19 patients diagnosed with PTL at the affiliated hospital of Southwest Medical University in China from June 2011 to May 2019. According to the Bethesda system for reporting thyroid cytopathology, the CB sections were evaluated for the presence of single tumor cells. IHC was performed on CB. Results: The diagnostic accuracy for PTL of FNA, CB with smears, and the joint application of the three methods (FNA + CB + IHC) of our study with 19 cases was 68.4% (13/19), 83.3% (15/18), and 100% (17/17), respectively. Conclusion: The present study demonstrates that FNA has low sensitivity in diagnosing PTL, but the joint application of FNA, CB, and IHC might provide high diagnostic accuracy for lymphoma and should be applied in all cases where the clinical suspicion is high regardless of the FNA findings.

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Primary thyroid lymphoma: a case series

Sakhri,

Zemni,

Ayadi

et al. 2024

J Med Case Reports

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Introduction Primary Thyroid Lymphoma (PTL) is defined as lymphoma involving the thyroid gland alone or the thyroid gland and adjacent neck lymph nodes without contiguous spread or distant metastases at the time of diagnosis. Most thyroid lymphomas are B cell lymphomas, and 98% of all PTL cases are non-Hodgkin’s lymphoma. It is a rare disease accounting for around 5% of the thyroid neoplasms and 2% of extranodal lymphomas. If properly diagnosed and treated, the prognosis is favorable. Case presentation Five cases (three men and two women) of PTL were diagnosed and treated in our institute between January 2005 and September 2019. These are 5 cases of Caucasian origin. The mean age was 76.2 (range: 63–95 years); one patient had associated hypothyroid. One patient had a medical history of breast cancer; one was hypothyroid, and four were euthyroid at the diagnosis. In 4 of these patients, PTL started with compressive symptoms. No patients underwent fine needle aspiration cytology (FNAC) or biopsy for the diagnostic only. In sonography, two cases showed bilateral nodules with goiter; in the three cases it showed nodules in the lobe and isthmus. Technetium-99m scintigraphy was performed on only two patients. Bone Marrow Biopsy (BMB) showed normal cellularity in 4 cases and only one case showed tumor cells. LDH levels were increased in all cases. The extension was evaluated in all patients with cervical and thoracic CT scans, Bone Marrow Biopsy (BMB), beta-2 microglobulin, and serum lactate dehydrogenase (LDH) levels. Three cases were staged as IE and two cases as IIE. Three patients underwent total thyroidectomy; two of them underwent cervical lymph node dissection. Two patients underwent lobectomy. All were diagnosed with lymphoma postoperatively and all were diffuse large B cell lymphoma (DLBCL). One patient completed treatment with R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone), and two cases received adjuvant chemo-radiotherapy (30 Gy). Two patients died immediately after surgery. Conclusion PTL is a rare disease whose diagnosis should be considered in cases of rapidly growing goitres. Timely needle biopsy in suspected cases can avoid unnecessary surgery. Systemic treatment is required, depending on the stage of the tumour.

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Management for primary thyroid lymphoma: Experience from a single tertiary care centre in Taiwan

Cited by 6 publications

References 31 publications

Primary Thyroid Lymphoma : An Uncommon Etiology of Compressive Goiter

Primary Thyroid Lymphoma : An Uncommon Etiology of Compressive Goiter

The diagnosis of primary thyroid lymphoma by fine‐needle aspiration, cell block, and immunohistochemistry technique

Primary thyroid lymphoma: a case series

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