J Korean Med Sci.  2010 Mar;25(3):481-484. 10.3346/jkms.2010.25.3.481.

Primary T-cell Lymphoma of the Thyroid Associated with Hashimoto's Thyroiditis, Histologically Mimicking MALT-Lymphoma

• Kim NR
• Ko YH
• Lee YD

• KMID: 1778048
• DOI: http://doi.org/10.3346/jkms.2010.25.3.481

Abstract

Most of thyroid lymphomas are B-lineage, and T-cell lymphomas are rare. Here, we report a case of primary thyroid T-cell lymphoma associated with Hashimoto's thyroiditis. A 48-yr-old woman presented with incidentally found neck mass. Histologically, the resected right lobe of the thyroid was replaced by monomorphic small atypical lymphoid cells with lymphoepithelial lesion-like change, most of which were immunoreactive for CD3, CD8, betaF-1, and TIA-1. Peripheral T-cell lymphoma, unspecified, was finally diagnosed after molecular study for TCR-gamma gene rearrangement. This is the second case of cytotoxic T-cell lymphoma reported in the thyroid gland so far. Unique association between thyroid follicles and neoplastic lymphocytes may be characteristic feature of this type of T-cell lymphoma.

Keyword

Lymphoma, T-Cell; Thyroid Gland; T-Lymphocytes, Cytotoxic; Lymphoma, B-Cell, Marginal Zone

MeSH Terms

Female
Hashimoto Disease/*pathology
Humans
Lymphoma, B-Cell, Marginal Zone/*pathology
Lymphoma, T-Cell/*pathology
Middle Aged
T-Lymphocyte Subsets/immunology/pathology
T-Lymphocytes, Cytotoxic/immunology/pathology
Thyroid Gland/*pathology

Figure

• 

  Fig. 1 Low power view of thyroid shows diffuse effacement of normal architecture by lymphoid infiltrates (H&E. Original magnification ×100). Inset shows small atypical lymphocytes invading follicles, creating lymphoepithelial lesions (H&E. Original magnification ×400).

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  Fig. 2 Atypical small lymphocytes are stained with CD3 (Peroxidase. Original magnification ×400, A), CD8 (Peroxidase. Original magnification ×400, B), and cytoplasmic TIA-1-immunoreactivity (Peroxidase. Original magnification ×400, C). They are not stained with CD20 (Peroxidase. Original magnification ×400, D).

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  Fig. 3 Gene rearrangement study for TCR using PCR-SSCP analysis shows a monoclonal band. Lane M, 100 base pair DNA ladder marker; Lane v1-8, Vγ1-8 region; Lane v11, Vγ11 region; -, negative control.

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