Primary thyroid lymphoma(PTL)is an exceptionally rare and highly aggressive potentially curable malignant disease.We report three typical cases of PTL referred to our hospital.All three cases had long history of Hashi...Primary thyroid lymphoma(PTL)is an exceptionally rare and highly aggressive potentially curable malignant disease.We report three typical cases of PTL referred to our hospital.All three cases had long history of Hashimoto’s thyroiditis,and presented with progressively enlarging neck mass.The first two cases were confirmed by surgical biopsy to be diffuse large B cell lymphoma,and received radiotherapy combined with chemotherapy,or received only chemotherapy.The third case was confirmed by core needle biopsy to be mucosa-associated lymphoid tissue lymphoma,and received radiotherapy.In summary,confirmation of PTL diagnosis is essential for further clinical decisions.Core biopsy should be one of the most important methods to make the diagnosis of PTL,while the use of fine needle aspiration cytology alone is still limited in diagnosing PTL.展开更多
PAPILLARY thyroid carcinoma （PTC） is the most common thyroid cancer and consists of nearly 80% of all cases of thyroid cancer.1 It is asso- ciated with the lowest level of malignancy and an excellent prognosis. Prim...PAPILLARY thyroid carcinoma （PTC） is the most common thyroid cancer and consists of nearly 80% of all cases of thyroid cancer.1 It is asso- ciated with the lowest level of malignancy and an excellent prognosis. Primary thyroid lymphoma （PTL） is a lymphomatous process which develops in the thyroid without involvement of primary lymphoid organs or distant metastases at diagnosis.2 It is a rare malignancy that accounts for 1%-5% of all thyroid malignancies and less than 2% of all extranodal lymphomas. The incidence of PTL is one or two cases per million.2＇ 3 It occurs frequently in elder woman, with a peak incidence in the sixth decade of life.展开更多
Thyroid lymphoma is an unusual pathology. Different subtypes of lymphoma can present as primary thyroid lymphoma. This review illustrates via imaging, findings and treatment the need for accurate diagnosis and timely ...Thyroid lymphoma is an unusual pathology. Different subtypes of lymphoma can present as primary thyroid lymphoma. This review illustrates via imaging, findings and treatment the need for accurate diagnosis and timely treatment. Patients and methods: patient's chart, pathological findings and radiological images were reviewed in a retrospective analysis. Over several days, this 80 years old woman developed airway obstruction and rapid enlargement of her thyroid secondary to diffuse large B-cell lymphoma. She rapidly responded to her oncological protocol. Primary thyroid lymphoma is a rare disease. It is an important diagnosis to consider in patients presenting with rapidly enlarging neck masses. It is a treatable condition with fairly favorable overall survival even with the most aggressive histological subtypes.展开更多
Primary Thyroid Lymphoma (PTL) is an uncommon disease, although its incidence is of 5%. Ultrasound and Fine Needle Aspiration Cytology (FNAC) usually do not provide the diagnosis. Surgery is one of the treatment optio...Primary Thyroid Lymphoma (PTL) is an uncommon disease, although its incidence is of 5%. Ultrasound and Fine Needle Aspiration Cytology (FNAC) usually do not provide the diagnosis. Surgery is one of the treatment options because it enables histological diagnosis and can also relieve compression symptoms in patients with rapid growth cervical mass. We present 7 cases of PTL diagnosed in the last 10 years in our unit. Five were female (71.4%) and 2 were male (28.6%). The mean age was 64.2 (range: 40 - 81);4 patients (57.1%) had associated Hashimoto’s Thyroiditis (HT). One patient (14.2%) had concomitant Graves disease. 5 cases presented with compressive symptoms and cervical mass. Ultrasound was not diagnostic in any case. FNAC was diagnostic only in one patient (14.3%). Five patients underwent total thyroidectomy (71.4%). All the cases were diagnosed with lymphoma postoperatively. Two interventions consisted of left hemithyroidectomies (28.6%). No complications appeared. 5 patients (71.4%) were classified as Mucosa-Associated Lymphoid Tissue (MALT) lymphoma. We also observed 1 Follicular grade I lymphoma and 1 Burkitt case. When the extension study was done, 1 patient was at stage IIIE (14%), 2 at IIE (28.5%) and 4 at IE (57.14%). Rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) and Iphosphamide, ethoposide and high dose Cytarabine (IVAC) were the treatment scheme when chemotherapy was used (in three cases). Two cases were treated only with total thyroidectomy, and 2 with total thyroidectomy and rituximab, and the latter was MALT. Complete Remission (CR) was achieved in all patients in the first year. All are still alive and in CR. In our experience, PTL diagnose can be challenging before surgery. Although surgery is not the gold standard for treatment, when it is done, it should be curative in MALT lymphomas confined to the thyroid.展开更多
Background: The reports of clinical outcomes of patients treated with chemoradiotherapy for primary thyroid non-Hodgkin’s lymphoma are rare. We report our results of chemoradiotherapy for primary thyroid non-Hodgkin...Background: The reports of clinical outcomes of patients treated with chemoradiotherapy for primary thyroid non-Hodgkin’s lymphoma are rare. We report our results of chemoradiotherapy for primary thyroid non-Hodgkin’s lymphoma. Materials and Methods: The subjects were 67 patients with thyroid non-Hodgkin’s lymphoma among 269 patients with malignant lymphoma who received radiotherapy in our hospital during a period between May 1990 and June 2005. The patients included 16 men and 51 women, with a mean age of 66.2 ± 10.7 years (30 - 84 years). The disease stage was stage I in 42 patients, stage II in 24, and unclear in 1. The histologic type was B-cell lymphoma in 66 patients, MALT in 9, diffuse type in 52, follicular type in 5, and diffuse and follicular type in 1. CHOP chemotherapy regimen for malignant lymphoma patients was as follows. Intravenous drip infusion of cyclophosphamide 750 mg/m<sup>2</sup>, (drip) infusion of doxorubicin 50 mg/m<sup>2</sup>, and intravenous injection of vincristine 1.4 mg/m<sup>2</sup> were administered on day 1, followed by 5 consecutive days of oral prednisolone 100 mg/m<sup>2</sup>. This regimen was repeated every 3 weeks (21 days) in 6 to 8 courses. Modified CHOP chemotherapy regimen was as follows. Intravenous drip infusion of cyclophosphamide 600 mg/m<sup>2</sup>, intravenous (drip) infusion of doxorubicin 40 mg/m<sup>2</sup>, intravenous infusion of vindesine 3 mg/m<sup>2</sup>, and intravenous drip infusion of prednisolone 60 mg/body were administered on day 1, and intravenous prednisolone was changed to oral prednisolone with the dose tapered gradually. After completing one course of this regimen, two courses of radiotherapy (a total of 36 Gy) were performed, followed by 6 courses of the chemotherapy regimen at lower doses (80% of the initial doses) repeated once a month. Results: Results of chemoradiotherapy in all patients were excellent. The 15-year survival rate was over 80%. Although there were no significant differences in the results of chemoradiotherapy among different histologic types of thyroid malignant lymphoma, the survival rate was 100% for MALT type, as compared with poor results for diffuse large type or diffuse mixed type. The analysis of the results of chemoradiotherapy according to the stage of malignant thyroid lymphomas revealed that therapeutic results were significantly better in stage I than in stage II. Conclusion: The CHOP chemoradiotherapy regimen and modified CHOP chemoradiotherapy regimen were excellent for primary thyroid non-Hodgkin’s lymphoma.展开更多
Primary non-Hodgkin’s lymphoma of the thyroid gland was rarely described. We report the case of a 44-year-old man admitted for an anterior neck swelling, hoarseness and dyspnea. The chest radiograph showed a trachea ...Primary non-Hodgkin’s lymphoma of the thyroid gland was rarely described. We report the case of a 44-year-old man admitted for an anterior neck swelling, hoarseness and dyspnea. The chest radiograph showed a trachea deviation. He had no clinical, biological or radiological sign of other lymphoma locations. Ultrasound examination of the neck revealed a bilateral heterogeneous thyroid lesion. Cytology revealed lymphoid cells having high nuclear-cytoplasmic ratio with multiple and irregular nucleoli. An urgent thyroid surgery consisting of total thyroidectomy had been performed since the presence of compressive signs due to the tumor. The histopathological examination of a biopsy from the thyroid tissue confirmed a high-grade non-Hodgkin’s lymphoma. Then, L-thyroxin substitution therapy, chemotherapy and radiotherapy were initiated. A prolonged remission was noted.展开更多
The clinical course of chronic hepatitis C virus(HCV)infection is characterized by possible development of both liver and extrahepatic disorders. The tropism of HCV for the lymphoid tissue is responsible for several i...The clinical course of chronic hepatitis C virus(HCV)infection is characterized by possible development of both liver and extrahepatic disorders. The tropism of HCV for the lymphoid tissue is responsible for several immune-mediated disorders; a poly-oligoclonal B-lymphocyte expansion, commonly observed in a high proportion of patients with HCV infection, are responsible for the production of different autoantibodies and immune-complexes, such as mixed cryoglobulins. These serological alterations may characterize a variety of autoimmune or neoplastic diseases. Cryoglobulinemic vasculitis due to small-vessel deposition of circulating mixed cryoglobulins is the prototype of HCV-driven immune-mediated and lymphoproliferative disorders; interestingly, in some cases the disease may evolve to frank malignant lymphoma. In addition, HCV shows an oncogenic potential as suggested by several clinicoepidemiological and laboratory studies; in addition to hepatocellular carcinoma that represents the most frequent HCV-related malignancy, a causative role of HCV has been largely demonstrated in a significant percentage of patients with isolated B-cells nonHodgkin's lymphomas. The same virus may be also involved in the pathogenesis of papillary thyroid cancer, a rare neoplastic condition that may complicate HCVrelated thyroid involvement. Patients with HCV infection are frequently asymptomatic or may develop only hepatic alteration, while a limited but clinically relevant number can develop one or more autoimmune and/or neoplastic disorders. Given the large variability of their prevalence among patients' populations from different countries, it is possible to hypothesize a potential role of other co-factors, i.e., genetic and/or environmental, in the pathogenesis of HCV-related extra-hepatic diseases.展开更多
文摘Primary thyroid lymphoma(PTL)is an exceptionally rare and highly aggressive potentially curable malignant disease.We report three typical cases of PTL referred to our hospital.All three cases had long history of Hashimoto’s thyroiditis,and presented with progressively enlarging neck mass.The first two cases were confirmed by surgical biopsy to be diffuse large B cell lymphoma,and received radiotherapy combined with chemotherapy,or received only chemotherapy.The third case was confirmed by core needle biopsy to be mucosa-associated lymphoid tissue lymphoma,and received radiotherapy.In summary,confirmation of PTL diagnosis is essential for further clinical decisions.Core biopsy should be one of the most important methods to make the diagnosis of PTL,while the use of fine needle aspiration cytology alone is still limited in diagnosing PTL.
基金Supported by the Natural Science Foundation of China(81541131)
文摘PAPILLARY thyroid carcinoma （PTC） is the most common thyroid cancer and consists of nearly 80% of all cases of thyroid cancer.1 It is asso- ciated with the lowest level of malignancy and an excellent prognosis. Primary thyroid lymphoma （PTL） is a lymphomatous process which develops in the thyroid without involvement of primary lymphoid organs or distant metastases at diagnosis.2 It is a rare malignancy that accounts for 1%-5% of all thyroid malignancies and less than 2% of all extranodal lymphomas. The incidence of PTL is one or two cases per million.2＇ 3 It occurs frequently in elder woman, with a peak incidence in the sixth decade of life.
基金Supported by The New York University Medical Center Institutional Review Board,New York,NY 10016,United States
文摘Thyroid lymphoma is an unusual pathology. Different subtypes of lymphoma can present as primary thyroid lymphoma. This review illustrates via imaging, findings and treatment the need for accurate diagnosis and timely treatment. Patients and methods: patient's chart, pathological findings and radiological images were reviewed in a retrospective analysis. Over several days, this 80 years old woman developed airway obstruction and rapid enlargement of her thyroid secondary to diffuse large B-cell lymphoma. She rapidly responded to her oncological protocol. Primary thyroid lymphoma is a rare disease. It is an important diagnosis to consider in patients presenting with rapidly enlarging neck masses. It is a treatable condition with fairly favorable overall survival even with the most aggressive histological subtypes.
文摘Primary Thyroid Lymphoma (PTL) is an uncommon disease, although its incidence is of 5%. Ultrasound and Fine Needle Aspiration Cytology (FNAC) usually do not provide the diagnosis. Surgery is one of the treatment options because it enables histological diagnosis and can also relieve compression symptoms in patients with rapid growth cervical mass. We present 7 cases of PTL diagnosed in the last 10 years in our unit. Five were female (71.4%) and 2 were male (28.6%). The mean age was 64.2 (range: 40 - 81);4 patients (57.1%) had associated Hashimoto’s Thyroiditis (HT). One patient (14.2%) had concomitant Graves disease. 5 cases presented with compressive symptoms and cervical mass. Ultrasound was not diagnostic in any case. FNAC was diagnostic only in one patient (14.3%). Five patients underwent total thyroidectomy (71.4%). All the cases were diagnosed with lymphoma postoperatively. Two interventions consisted of left hemithyroidectomies (28.6%). No complications appeared. 5 patients (71.4%) were classified as Mucosa-Associated Lymphoid Tissue (MALT) lymphoma. We also observed 1 Follicular grade I lymphoma and 1 Burkitt case. When the extension study was done, 1 patient was at stage IIIE (14%), 2 at IIE (28.5%) and 4 at IE (57.14%). Rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) and Iphosphamide, ethoposide and high dose Cytarabine (IVAC) were the treatment scheme when chemotherapy was used (in three cases). Two cases were treated only with total thyroidectomy, and 2 with total thyroidectomy and rituximab, and the latter was MALT. Complete Remission (CR) was achieved in all patients in the first year. All are still alive and in CR. In our experience, PTL diagnose can be challenging before surgery. Although surgery is not the gold standard for treatment, when it is done, it should be curative in MALT lymphomas confined to the thyroid.
文摘Background: The reports of clinical outcomes of patients treated with chemoradiotherapy for primary thyroid non-Hodgkin’s lymphoma are rare. We report our results of chemoradiotherapy for primary thyroid non-Hodgkin’s lymphoma. Materials and Methods: The subjects were 67 patients with thyroid non-Hodgkin’s lymphoma among 269 patients with malignant lymphoma who received radiotherapy in our hospital during a period between May 1990 and June 2005. The patients included 16 men and 51 women, with a mean age of 66.2 ± 10.7 years (30 - 84 years). The disease stage was stage I in 42 patients, stage II in 24, and unclear in 1. The histologic type was B-cell lymphoma in 66 patients, MALT in 9, diffuse type in 52, follicular type in 5, and diffuse and follicular type in 1. CHOP chemotherapy regimen for malignant lymphoma patients was as follows. Intravenous drip infusion of cyclophosphamide 750 mg/m<sup>2</sup>, (drip) infusion of doxorubicin 50 mg/m<sup>2</sup>, and intravenous injection of vincristine 1.4 mg/m<sup>2</sup> were administered on day 1, followed by 5 consecutive days of oral prednisolone 100 mg/m<sup>2</sup>. This regimen was repeated every 3 weeks (21 days) in 6 to 8 courses. Modified CHOP chemotherapy regimen was as follows. Intravenous drip infusion of cyclophosphamide 600 mg/m<sup>2</sup>, intravenous (drip) infusion of doxorubicin 40 mg/m<sup>2</sup>, intravenous infusion of vindesine 3 mg/m<sup>2</sup>, and intravenous drip infusion of prednisolone 60 mg/body were administered on day 1, and intravenous prednisolone was changed to oral prednisolone with the dose tapered gradually. After completing one course of this regimen, two courses of radiotherapy (a total of 36 Gy) were performed, followed by 6 courses of the chemotherapy regimen at lower doses (80% of the initial doses) repeated once a month. Results: Results of chemoradiotherapy in all patients were excellent. The 15-year survival rate was over 80%. Although there were no significant differences in the results of chemoradiotherapy among different histologic types of thyroid malignant lymphoma, the survival rate was 100% for MALT type, as compared with poor results for diffuse large type or diffuse mixed type. The analysis of the results of chemoradiotherapy according to the stage of malignant thyroid lymphomas revealed that therapeutic results were significantly better in stage I than in stage II. Conclusion: The CHOP chemoradiotherapy regimen and modified CHOP chemoradiotherapy regimen were excellent for primary thyroid non-Hodgkin’s lymphoma.
文摘Primary non-Hodgkin’s lymphoma of the thyroid gland was rarely described. We report the case of a 44-year-old man admitted for an anterior neck swelling, hoarseness and dyspnea. The chest radiograph showed a trachea deviation. He had no clinical, biological or radiological sign of other lymphoma locations. Ultrasound examination of the neck revealed a bilateral heterogeneous thyroid lesion. Cytology revealed lymphoid cells having high nuclear-cytoplasmic ratio with multiple and irregular nucleoli. An urgent thyroid surgery consisting of total thyroidectomy had been performed since the presence of compressive signs due to the tumor. The histopathological examination of a biopsy from the thyroid tissue confirmed a high-grade non-Hodgkin’s lymphoma. Then, L-thyroxin substitution therapy, chemotherapy and radiotherapy were initiated. A prolonged remission was noted.
文摘The clinical course of chronic hepatitis C virus(HCV)infection is characterized by possible development of both liver and extrahepatic disorders. The tropism of HCV for the lymphoid tissue is responsible for several immune-mediated disorders; a poly-oligoclonal B-lymphocyte expansion, commonly observed in a high proportion of patients with HCV infection, are responsible for the production of different autoantibodies and immune-complexes, such as mixed cryoglobulins. These serological alterations may characterize a variety of autoimmune or neoplastic diseases. Cryoglobulinemic vasculitis due to small-vessel deposition of circulating mixed cryoglobulins is the prototype of HCV-driven immune-mediated and lymphoproliferative disorders; interestingly, in some cases the disease may evolve to frank malignant lymphoma. In addition, HCV shows an oncogenic potential as suggested by several clinicoepidemiological and laboratory studies; in addition to hepatocellular carcinoma that represents the most frequent HCV-related malignancy, a causative role of HCV has been largely demonstrated in a significant percentage of patients with isolated B-cells nonHodgkin's lymphomas. The same virus may be also involved in the pathogenesis of papillary thyroid cancer, a rare neoplastic condition that may complicate HCVrelated thyroid involvement. Patients with HCV infection are frequently asymptomatic or may develop only hepatic alteration, while a limited but clinically relevant number can develop one or more autoimmune and/or neoplastic disorders. Given the large variability of their prevalence among patients' populations from different countries, it is possible to hypothesize a potential role of other co-factors, i.e., genetic and/or environmental, in the pathogenesis of HCV-related extra-hepatic diseases.
