Endocrine Abstracts

JOINT939

Introduction: Primary thyroid lymphomas are rare (2-5% of thyroid cancers and less than 5% of extra-ganglionic lymphomas). The most frequent types are B-cell lymphoma and MALT lymphoma. Posing a diagnosis problem, including differential diagnosis with anaplastic cancer. We report two different cases of thyroid lymphoma.

Observation: Case 1: 44-year-old patient, with no particular history, who consulted for a rapidly increasing goiter, cervical ultrasound found a mass classified as Eutirads 4 of 83x47mm at the expense of the right lobe on thyroiditis; thoracic CT scan confirmed the tumor which was expansive, infiltrative and compressive, plunging into the mediastinum. In view of dyspnea, a tracheotomy was performed. A biopsy returned in favor of a diffuse large cell lymphoma BCD20+, BCL6- chemotherapy Rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone (RCHOP) was initiated. After 6 courses, the PET-SCAN found a Deauville score of 3 in complete metabolic response. Case 2: 62-year-old patient who presented 3 months previously with a pathological fracture of the right leg on an osteolytic mass, the anatomopathological study returned in favor of a large B-cell lymphoma. The extension assessment found a large goiter at the expense of the left lobe with a large left totolobar nodule Eutirads 5 with adenopathies of which the biopsy found a diffuse large B-cell lymphoma, i.e. a second location, chemotherapy (RCHOP) was initiated.

Discussion: The risk of developing thyroid lymphoma is multiplied by 67 in case of lymphocytic thyroiditis. Because of their rarity and their clinical polymorphism, thyroid lymphomas have revealed diagnostic difficulties. Therapeutic conduct is currently well codified. Their prognosis, depending on the histology and stage of the disease, was favorable with a 5-year survival rate of 70 to 80%.

Conclusion: Due to the different therapeutic management, thyroid lymphoma is a diagnosis that must be mentioned in front of any cervical mass with rapid evolution, especially if there is a history of thyroiditis