Korean J Endocr Surg.  2016 Jun;16(2):51-55. 10.16956/kaes.2016.16.2.51.

The Primary Thyroid Lymphoma Treated by Surgery without Chemotherapy: Two Cases Reports

• Park EH
• Kim JH
• Kwak JY
• Park CS
• Kwak JH

• KMID: 2308571
• DOI: http://doi.org/10.16956/kaes.2016.16.2.51

Abstract

Primary thyroid lymphoma (PTL) is a relatively rare disease, accounting for less than 0.5~5% of all thyroid malignancies. We encountered two cases of a primary thyroid lymphoma with Hashimoto's thyroiditis; one in a 63-year-old man and the other in a 79-year-old woman. The first case was a mucosa-associated lymphoid tissue lymphoma, and the other was a diffuse large B-cell lymphoma. Both patients underwent surgery and radiotherapy after being diagnosed using fine-needle aspiration cytology (FNAC). Both patients recovered well with no recurrence throughout the study period. The role of the surgeon in the treatment and diagnosis of thyroid lymphoma has been reduced due to the development of FNAC and combination therapy with chemotherapy and radiotherapy. On the other hand, surgery can be an effective treatment option for PTL confined to the thyroid, for achieving a definitive diagnosis, and in the treatment of patients with an airway obstruction.

Keyword

Thyroid gland; Lymphoma; Large B-Cell; Thyroidectomy

MeSH Terms

Aged
Airway Obstruction
Biopsy, Fine-Needle
Diagnosis
Drug Therapy*
Female
Hand
Humans
Lymphoma*
Lymphoma, B-Cell
Lymphoma, B-Cell, Marginal Zone
Middle Aged
Radiotherapy
Rare Diseases
Recurrence
Thyroid Gland*
Thyroidectomy
Thyroiditis

Figure

• 

  Fig. 1 A 63-year-old man who was diagnosed with mucosa-associated lymphoid tissue (MALT) lymphoma. (A) Thyroid ultrasonography shows about 1.8×1.9×2.3 cm sized hypoehoic mass with ill-defined margin in right thyroid gland. (B) Thyroid fine needle aspiration cytology smear (Pap stain ×400) shows diffuse polymorphous lymphoid cells of medium sized cleaved, large round, and small round nuclei. (C) histopathology of thyroid (H&E, ×200). Lymphoid cells invade and expand the thyroid follicles, forming the lymphoepithelial lesion. The lymphoid cell have cleaved centrocyte-like nuclei or small round nuclei. (D) Immumohistochemical stain show CD20+ and (E) bcl2+.

• 

  Fig. 2 A 79-year-old woman who was diagnosed with diffuse large B-cell lymphoma. (A) Preoperative CT scan shows a diffusedly enlarged thyroid gland with (B) narrowed tracheal diameter and extended to the thoracic inlet. (C) Postoperative positron emission tomography shows only a focal hyper-metabolic lesion in the right thyroid surgical bed. (D) Microscopically, there is a diffuse infiltration of large monomorphic lymphoid cells in the thyroid (H&E, ×200).

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