primary thyroid lymphoma
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Introduction
Non-Hodgkin's lymphoma where the thyroid is the predominant or exclusive site of involvement. Approximately 10% of systemic lymphoma or leukemia have thyroid involvement.
Etiology
- frequently associated with Hashimoto's thyroiditis
Epidemiology
- 1-5% of thyroid cancers
- most common in women over 55 years of age
Pathology
- diffuse large B cell lymphoma is most common
- MALT lymphoma most common[1]
- antigenic stimulation due to Hashimoto's thyroiditis may play a role[2]
- aberrant somatic hypermutation may play a role[2]
Clinical manifestations
- enlarging neck mass (weeks)
- local compression on adjacent structures
- B symptoms of lymphoma may be present
Laboratory
Diagnostic procedures
- core needle biopsy or excisional biopsy to establish diagnosis of lymphoma
Radiology
- computed tomography of neck
- diffusely enlarged thyroid
- may show compression of trachea
Management
- MALT lymphomas respond to chemotherapy[1]
- chemotherapy &/or radiation therap
- thyroidectomy generally not needed[1]
More general terms
References
- ↑ Jump up to: 1.0 1.1 1.2 1.3 Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 17, 18. American College of Physicians, Philadelphia 1998, 2012, 2015, 2018.
- ↑ Jump up to: 2.0 2.1 2.2 Graff-Baker A, Sosa JA, Roman SA. Primary thyroid lymphoma: a review of recent developments in diagnosis and histology-driven treatment. Curr Opin Oncol. 2010 Jan;22(1):17-22. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19844180
- ↑ Kim HC, Han MH, Kim KH et al Primary thyroid lymphoma: CT findings. Eur J Radiol. 2003 Jun;46(3):233-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12758117