Endocrine Abstracts (2011) 26 P487

Synchronous thyroid and gastric diffuse large B cell lymphoma

Mustafa Altay, Fusun Balos Toruner, Fatih Karakaya, Nuri Cakir & Metin Arslan

Gazi University Medical Faculty, Ankara, Turkey.

Introduction: Thyroid lymphoma is a rare disease. Furthermore, coincidence of extrathyroidal lymphoma is very rare.

Case: A 69 years-old woman patient was admitted to the hospital with dyspnea, hoarse voice and swelling of throat for a month. In her history, she had been diagnosed as gastric lymphoma 6 years ago, while she was being investigated for upper gastrointestinal bleeding. Six cures of chemotherapy has been applied. She was not on follow up. In physical examination, she looked cachectic and dyspneic. Thyroid was enlarged diffusely and multiple nodules were palpated. Trachea was shifted and pressed by the thyroid. Laboratory tests were as follows: Hgb: 10.1 g/dl, TSH: 0.8 μIU/ml (0.6–4.8), fT4:1.1 ng/dl (0.74–1.52), fT3: 1.3 pg/ml (2.3–4.2), anti-TPO: 133 U/ml (0–57), anti-T: 130 U/ml (0–64), TG: 155 (1.6–59.9) ng/ml. Thyroid ultrasonography revealed chronic thyroiditis and multinodular goitre. FNA biopsy was performed to the nodules and diffuse large B cell lymphoma (CD 20 was positive, CD3 and CD30 were negative) was detected. Also, diffuse large B cell lymphoma was revealed at the endoscopic gastric biopsy specimen, too (CD 20 and bcl-6 were positive and Ki-67 proliferation index was 99%). At radiolological evaluation for the staging of disease, subcarinal and paratracheal lymphadenopathies and multiple nodules in each of the lungs were detected. Because her performans status was poor, bronchoscopy could not be applied. After several days, her performance status worsened and she died.

Conclusion: In this case report, we purposed to remind that thyroid nodules which were developed on the base of chronic thyroiditis should be immediately evaluated for lymphoma, especially in cases which gastric or another organ lymphoma had been detected synchronously.

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