Primary non‐Hodgkin's lymphoma of the thyroid gland: a population based study

Abstract

During a 9-year-period, 50 cases of primary non-Hodgkin's lymphoma (NHL) of the thyroid gland were reported to a population-based lymphoma registry covering western Denmark giving an incidence of 2.06 x 10(-6) cases per year. The male:female ratio was 1:4, and the mean age was 72.8 years for women and 62.8 years for men. On histomorphological reclassification 83% of the cases showed a high grade and 17% a low grade morphology, 98% had a B-phenotype and 2% a T-phenotype. In at least 33 of the cases, primary NHL of the thyroid gland was preceded by Hashimoto's thyroiditis and at least 25 of the patients had a high grade NHL which was transformed from Hashimoto's thyroiditis through a low grade B-cell lymphoma of MALT type. The most frequent presenting symptoms were goitre (100%), hoarseness (57%), stridor/dyspnoea (55%) and dysphagia (45%); thirty-six percent of the patients were hypothyroid at the time of diagnosis. Seventy-six percent of the patients had localized disease (stages 1-2) and 24% had disseminated lymphoma (stages 3-4). Five year survival was 34.5% and 5 year cause-specific survival 46.2%. The following factors were associated with a poor prognosis: stage 3-4 disease, elevated S-urate, presence of hoarseness and age> 66 years. Morphological subtype did not correlate significantly with survival.

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

“…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].…”

“…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].…”

“…Age range of these cases was between 34 and 86 years with a male to female ratio of 1.15:1. Most of the reported cases showed a low grade behavior on follow up unlike the aggressive behavior seen in conventional TCL [3,9]. Microscopic morphology, in these cases, is variable showing most commonly a small lymphocytic infiltrate invading the thyroid follicles, also forming lymphoepithelial bodies in some cases [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Primary thyroid MALToma– a rare diagnosis of an unassuming thyroid nodule

“…Primary thyroid MALT lymphoma is rare, accounting 6–28% of PTLs [5] and usually arises in the setting of chronic lymphocytic thyroiditis, such as Hashimoto’s thyroiditis [2]. The mean and median ages at diagnosis is between 65 and 75 years with 4:1 female predominance [5–7]. Co-occurrence of papillary thyroid carcinoma has also been reported [3,8].…”