Abstract
Introduction
Primary thyroid lymphoma (PTL) is a rare malignant disease, which can be life threatening because of airway obstruction due to a suddenly and rapidly growing mass. Prompt and accurate detection and diagnosis in the early phase of PTL are crucial for the treatment of this disease. However, due to lack of standardized diagnostic procedures and methods, PTL can be easily missed or misdiagnosed.
Materials and methods
In this study, we retrospectively reviewed 12 thyroid lymphomas cases to determine the typical clinical and sonographic profiles of thyroid lymphomas.
Results
All the patients showed symptoms of rapidly developing neck swelling or mass sensation when they underwent diagnostic procedures. We found that, in sonography, 3 of the 12 patients (25.0 %) showed diffuse heterogeneous hypoechoic parenchyma with intervening echogenic septa-like structures, 8 (66.7 %) showed markedly hypoechoic masses, and 1 (8.3 %) showed a mixed pattern. Histological analysis of the lymphomas using paraffin-embedded sections revealed that all the 12 lymphomas were non-Hodgkin lymphoma with a B cell origin: extranodal marginal zone B cell lymphomas of the mucosa-associated lymphoid tissue lymphoma type in 3 (MALT, 25.0 %), and diffuse large B cell lymphomas in 9 (75.0 %) lymphomas. All the MALT patients had diffuse heterogeneous hypoechoic parenchyma in sonography, but only one of them with diffuse large B cell lymphomas had diffuse heterogeneous hypoechoic parenchyma in sonography. Complete remission was achieved in all patients when they were given CHOP or COP therapy accompanied by local radiotherapy after accurate diagnosis of PTL.
Conclusion
We analyzed clinical, sonographic and histological features of twelve cases of malignant lymphoma arising in the thyroid gland and proposed a systematic strategy for prompt and accurate diagnosis of PTL.
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References
Walsh S, Lowery AJ, Evoy D et al (2013) Thyroid lymphoma: recent advances in diagnosis and optimal management strategies. Oncologist 18:994–1003
Green LD, Mack L, Pasieka JL (2006) Anaplastic thyroid cancer and primary thyroid lymphoma: a review of these rare thyroid malignancies. J Surg Oncol 94:725–736
Fujita A, Tomita N, Fujita H et al (2009) Features of primary extranodal lymphoma in Kanagawa, a human T cell leukemia virus type 1 nonendemic area in Japan. Med Oncol 26:49–54
Cheng V, Brainard J, Nasr C (2012) Co-occurrence of papillary thyroid carcinoma and primary lymphoma of the thyroid in a patient with long-standing Hashimoto’s thyroiditis. Thyroid 22:647–650
Thieblemont C, Mayer A, Dumontet C et al (2002) Primary thyroid lymphoma is a heterogeneous disease. J Clin Endocrinol Metab 87:105–111
Stein SA, Wartofsky L (2013) Primary thyroid lymphoma: a clinical review. J Clin Endocrinol Metab 98:3131–3138
Hahn JS, Chung HC, Min YH et al (1995) Primary lymphoma of the thyroid. Yonsei Med J 36:315–321
Ota H, Ito Y, Matsuzuka F et al (2006) Usefulness of ultrasonography for diagnosis of malignant lymphoma of the thyroid. Thyroid 16:983–987
Nam M, Shin JH, Han BK et al (2012) Thyroid lymphoma: correlation of radiologic and pathologic features. J Ultrasound Med 31:589–594
Gupta N, Nijhawan R, Srinivasan R et al (2005) Fine needle aspiration cytology of primary thyroid lymphoma: a report of ten cases. Cytojournal 2:21
Amonkar G, Jashnani K, Shet T et al (2007) Diagnostic fine needle aspiration cytology of primary thyroid lymphoma. J Cytol 24:140–141
Yeshvanth SK, Lakshminarayana KP, Upadhyaya VS et al (2012) Primary thyroid lymphoma arising from Hashimotos thyroiditis diagnosed by fine needle aspiration cytology. J Cancer Res Ther 8:159–161
Cha H, Kim JW, Suh CO et al (2013) Patterns of care and treatment outcomes for primary thyroid lymphoma: a single institution study. Radiat Oncol J 31:177–184
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The authors declare no conflict of interest.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments and comparable standards. This article does not contain any studies with animals performed by any of the authors.
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Informed consent was obtained from all individual participants included in the study.
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Yang, L., Wang, A., Zhang, Y. et al. 12 cases of primary thyroid lymphoma in China. J Endocrinol Invest 38, 739–744 (2015). https://doi.org/10.1007/s40618-015-0250-6
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DOI: https://doi.org/10.1007/s40618-015-0250-6