Background: Primary thyroid lymphoma (PTL) is a rare thyroid malignancy. Nevertheless, it frequently presents diagnostic and therapeutic challenges. We describe two patients with PTL with different clinical presentation/clinical picture and outcome.
Patients and methods: Two female patients underwent total thyroidectomy, the first, a 67-year-old female patient, because of nodular goitre and the second, a 79-year-old female patient, because of a large, painless thyroid mass accompanied by severe obstructive symptoms of the upper respiratory and gastrointestinal track.
Results: Histology of the first patient revealed lymphocytic thyroiditis and a small focus of previously unsuspected PTL, coexistent with an occult papillary thyroid carcinoma (PTC). The PTL was an incidental finding and 2 years after thyroidectomy she is free of disease without any further treatment. Histology of the second patient confirmed the clinical suspicion of PTL and established the diagnosis of a diffuse large B-cell lymphoma. Although she underwent standard chemotherapy, she died four months later.
Conclusions: PTL may have an aggressive and lethal course on the one end of the spectrum and the other one may be quite indolent. Our two cases confirm the heterogeneous nature of PTL.