Radical Surgery for Primary Thyroid Lymphoma in Elderly Patients: A Short Report

Document Type : Case Report

Authors

Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Primary thyroid lymphoma (PTL) is a rare neoplasm that requires early and accurate diagnosis, as its approach and management is different from other thyroid malignancies. Primary thyroid lymphoma (PTL) usually presents with rapidly growing neck mass with pressure symptoms. We report two elderly females with PTL who developed a painless enlarging thyroid mass. They had no medical history or family history of thyroid disease. Based on clinical symptoms and radiologic findings, both of them underwent surgical resection of the tumors. Ultrasonography and CT scan showed no specific findings, and like Hashimoto's thyroiditis, only a large diffuse thyroid with nodular tissue was found. Postoperative histologic examination revealed high-grade non-Hodgkin lymphoma. Overall, these cases emphasize the importance of considering Primary thyroid lymphoma (PTL) when dealing with large thyroid tumors. Although the treatment of choice for Primary thyroid lymphoma (PTL) is chemoradiotherapy, surgery could be performed when the diagnosis is inconclusive or has compressive symptoms.

Keywords


  1. Sakorafas GH, Kokkoris P, Farley DR. Primary thyroid lympoma: Diagnostic and therapeutic dilemmas. Surgical oncology. 2010 Dec 1;19(4):e124-9.
  2. Bostanci H, Dikmen K, Akyürek N, BÜYÜKKASAP AÇ, Yavuz A, Yalcin MM, et al. Eleven patients with primary thyroid lymphoma: a single center experience. Turkish Journal of Medical Sciences. 2017;47(5):1322-7..
  3. Allaoui M, Benchafai I, Mahtat EM, Regragui S, Boudhas A, Azzakhmam M, et al. Primary Burkitt lymphoma of the thyroid gland: case report of an exceptional type of thyroid neoplasm and review of the literature. BMC Clinical Pathology. 2016 Dec;16(1):1-6.
  4. Verma D, Puri V, Agarwal S, Bhaskar A. Primary thyroid lymphoma: a rare disease. Journal of Cytology/Indian Academy of Cytologists. 2014 Oct;31(4):218.
  5. Büyükaşık O, Hasdemir AO, Yalçın E, Celep B, Şengül S, Yandakçı K, et al. The association between thyroid malignancy and chronic lymphocytic thyroiditis: should it alter the surgical approach?. Endokrynologia Polska. 2011;62(4):303-8.
  6. Jayaprakash KS, Kishanprasad HL, Hegde P, Chandrika R. Hashimotos Thyroiditis with Coexistent Papillary Carcinoma and Non. hodgkin Lymphoma. thyroid. Annals of Medical and Health Sciences Research. 2014;4(2):268-70.
  7. Xie S, Liu W, Xiang Y, Dai Y, Ren J. Primary thyroid diffuse large B‐cell lymphoma coexistent with papillary thyroid carcinoma: A case report. Head & Neck. 2015 Sep;37(9):E109-14.
  8. Travaglino A, Pace M, Varricchio S, Insabato L, Giordano C, Picardi M, et al. Hashimoto thyroiditis in primary thyroid non-Hodgkin lymphoma: a systematic review and meta-analysis. American journal of clinical pathology. 2020 Jan 2;153(2):156-64.
  9. Gupta N, Nijhawan R, Srinivasan R, Rajwanshi A, Dutta P, Bhansaliy A, et al. Fine needle aspiration cytology of primary thyroid lymphoma: a report of ten cases. Cytojournal. 2005;2:21.
  10. Nguyen GK, Lee MW, Ginsberg J, Wragg T, Bilodeau D. Fine-needle aspiration of the thyroid: an overview. Cytojournal. 2005;2:12.
  11. Walsh S, Lowery AJ, Evoy D, McDermott EW, Prichard RS. Thyroid lymphoma: recent advances in diagnosis and optimal management strategies. The oncologist. 2013 Sep;18(9):994-1003.