Primary thyroid lymphomas
Amada Guimón, Dolores Moure, Teresa Ruiz de Azua, Javier Santamaría & Sonia Gaztambide
Primary lymphomas of the thyroid are uncommon tumours, constituting fewer than 2% of all thyroid malignancies. For this reason their clinical features are not very well known. It seems that most of them arise in patients who have chronic autoimmune thyroiditis.
From our patients with primary thyroid cancer since 1995, we selected those with pathological diagnosis of thyroid lymphoma. Epidemiological data, clinical features and response to treatment were analysed.
We found 7 patients, all of them women, with an age of 66±25.3 years (X±S.D.). They were referred as a painless, rapidly enlarging (median 3 months), neck mass (7±2.2 cm). Six out of 7 cases presented lymph node enlargement. Thyroid function was normal in 5 cases, and subclinical hypothyroidism was present in the other two. AntiTPO antibodies were positive in 2 out of 7 cases. The diagnosis of lymphoma was established by FNA in 6 out of 7 patients. Chemotherapy was indicated in all cases except in one patient who was older and had a short life prognosis. Neck radiotherapy was associated in 2 cases. The mean time of follow up was 40.43±55.6 months. Two patients died 3 and 24 months after the diagnosis. These patients were older than the others (87±7.07 versus 57.6±25.35 years).
In summary, thyroid lymphomas are referred as a rapidly enlarging neck mass. The absence of thyroid autoimmunity does not rule out the diagnosis. A good response to chemotherapy was observed, except in older patients.