Primary Thyroid Lymphoma Associated with Graves' Disease

Doi, Yasuko; Goto, Aya; Murakami, Tsukasa; Yamashita, Hiroto; Yamashita, Hiroyuki; Noguchi, Shiro

doi:10.1089/thy.2004.14.772

Cited by 11 publications

(2 citation statements)

References 14 publications

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“…According to some authors, Hashimoto thyroiditis is considered the most important risk factor for PTL appearance and a moderate risk factor for the papillary thyroid carcinoma [ 2 , 3 ]. The connection between Graves´ disease and PTL has also been described [ 15 ]. It seems that chronic antigenic stimulation of lymphocytes might have a role in DLBCL growth, while chronic inflammation can induce synthesis of cyclooxigenase-2, present in both, Hashimoto thyroiditis and thyroid carcinoma [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Two lymphoma histotypes and papillary thyroid carcinoma coexisting on Hashimoto ground: a case report and review of the literature

Iskra,

Tomaš,

Crnčić

et al. 2024

Diagn Pathol

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Background Papillary carcinoma is the most frequent type of thyroid carcinoma, while primary thyroid lymphoma is uncommon disease. The coexistence of these entities has already been described, and the common risk factor is considered Hashimoto thyroiditis. The two most frequent histotypes of primary thyroid lymphoma are diffuse large B-cell and mucosa-associated lymphoid tissue lymphoma, but the coexistence of both with papillary carcinoma is rarely reported. Methods We present a case of a previously healthy 57-years old male with rapidly growing lump on the right side of the neck. Ultrasonography revealed nodules in both thyroid lobes. Fine needle aspiration cytology and pertechnetate scintigraphy were performed. Due to the Bethesda T-5 in the “cold” nodule of the right lobe, surgery with histopathological and immunohistochemistry analysis was indicated. Results Histopathological and immunohistochemistry methods confirmed concomitant malignancies in the thyroid gland: diffuse large B-cell lymphoma and papillary carcinoma in the right, and mucosa-associated lymphoid tissue lymphoma in the left lobe with Hashimoto thyroiditis in the remaining tissue. Patient underwent therapy procedures and was without signs of local recurrence or metastatic spread on subsequent follow-up. Conclusions Sudden appearance of the neck mass in patients with Hashimoto thyroiditis should raise suspicion on primary thyroid lymphoma and be promptly taken in the diagnostic workup, including fine needle aspiration cytology. Pathology with immunohistochemistry is crucial for further clinical decision making. Since the standardized protocol in management of these complex patients is missing, personal approach and close collaboration between cytologist, pathologist, surgeon, haematologist and nuclear medicine specialist is essential.

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Section: Discussionmentioning

confidence: 99%

Two lymphoma histotypes and papillary thyroid carcinoma coexisting on Hashimoto ground: a case report and review of the literature

Iskra,

Tomaš,

Crnčić

et al. 2024

Diagn Pathol

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“…Yamashita et al have also reported vitamin D deficiency in 40% of women and in 18% of men having GD from Japan [25]. In another study from Japan, Doi et al showed that 35% of patients with thyrotoxicosis had vitamin D deficiency [26]. Other studies have also shown a significant impact of 25OHD3 deficiency on bone structure and bone metabolism [27][28][29].…”

Section: Introductionmentioning

confidence: 95%

Vitamin D and bone metabolism in Graves' disease. A prospective study

Khamisi¹,

Lundquist²,

Rasmusson³

et al. 2022

EJEA

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Purpose Vitamin D and osteoporosis in Graves' disease (GD) have been examined in cross-sectional studies with divergent results. Here, we prospectively studied vitamin D metabolism and bone health in patients with newly diagnosed GD. Methods Thirty consecutive patients with de novo overt thyrotoxicosis diagnosed with GD were included. At diagnosis, none of the patients were treated with vitamin D or anti-osteoporotic drugs. All patients were initially treated with antithyroid drugs. Blood samplings were taken at baseline and at 6 weeks, 3, 6, 12 and 24 months after treatment start. Serum levels of 25OHD3, 1,25OH2D3, calcium, parathyroid hormone (PTH), and C-terminal telopeptides of Type I collagen (CTX-I) were analysed. Bone mineral density (BMD) was measured at baseline, and 1 and 2 years after treatment initiation. Results At diagnosis, patients with GD did not have vitamin D deficiency. There were no significant correlations between levels of 25OHD3 and thyrotoxicosis. Upon treatment of the thyrotoxicosis, serum calcium fell transiently, and PTH and 1,25OH2D3 increased. 25OHD3 fell within the normal range and stabilised at 6 months. CTX-I fell over 12 months, BMD increased significantly up to 2 years, p = 0.002, < 0.001 and 0.005 in the spine, left total hip and left femoral neck, respectively. Conclusions The present data underline that thyrotoxicosis has a negative impact on bone health and demonstrate fine-tuned dynamics in bone and vitamin D metabolism. Upon treatment, bone health improved over a follow-up period of 24 months despite rising PTH. Increased conversion of 25OHD3 to 1,25OH2D3 occurs during treatment of GD.

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Cytologic features of mixed papillary carcinoma and chronic lymphocytic leukemia/small lymphocytic lymphoma of the thyroid gland

Reid-Nicholson

Moreira

Ramalingam

2008

Diagnostic Cytopathology

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We report a case of papillary thyroid carcinoma (PTC) and chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma of the thyroid gland. To the best of our knowledge, this is the first such case to be reported in the cytology literature. An 81-year-old male with known CLL presented for routine physical examination and was found to have a left-sided thyroid nodule. Thyroid ultrasound showed a calcified nodule. Fine-needle aspiration biopsy (FNAB) was performed and revealed PTC and an atypical lymphoid infiltrate that was suspicious for lymphoma. A partial thyroidectomy was performed and confirmed PTC with concurrent gland involvement by chronic lymphocytic leukemia/small lymphocytic lymphoma (SLL).

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Primary Thyroid Lymphoma Associated with Graves' Disease

Cited by 11 publications

References 14 publications

Two lymphoma histotypes and papillary thyroid carcinoma coexisting on Hashimoto ground: a case report and review of the literature

Two lymphoma histotypes and papillary thyroid carcinoma coexisting on Hashimoto ground: a case report and review of the literature

Vitamin D and bone metabolism in Graves' disease. A prospective study

Cytologic features of mixed papillary carcinoma and chronic lymphocytic leukemia/small lymphocytic lymphoma of the thyroid gland

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