Thyroid lymphomas are very rare diseases of the thyroid.
We present three patients with thyroid lymphoma administered our department last year. Two of the patients presented with rapidly enlarging neck mass with pressure symptoms, and the other was diagnosed during the evaluation of a thyroid nodule. Two patients had the Hashimotos thyroiditis diagnosis. All the patients underwent surgery, since no exact diagnosis could be established with fine feedle aspiration biopsy (US-FNAB). Decompression surgery or total thyroidectomy could not be performed because of hypervascularity of the masses in first two cases. Severe compression signs improved dramatically with the CHOP-R chemotherapy protocol in these patients. Third patient is still being evaluated for staging of lymphoma.
The differential diagnosis of thyroid lymphoma may be problemmatic since most common presentation which is rapidly enlarging neck mass can be confused with anaplastic thyroid cancer and B-symptoms are recorded only 10% of the patients. Relationship between Hashimotos thyroiditis and lymphomas still remains obscure. Suspicion is the most important step for diagnosing thyroid lymphoma. Ultrasonography, US-FNAB and adjunctive techniques (e.g. cytomorphological immunophenotypic and molecular techniques) appear to have an improved overall diagnostic accuracy. Surgery is not a treatment modality for thyroid lymphoma. Surgery may be performed because of the limitations of ultrasonography and US-FNAB for diagnosis or subclassifications of lymphoma.
25 - 29 Apr 2009
European Society of Endocrinology