Primary Lymphoma of Thyroid
Seema Khanna, Ram Niwas Meena, Mohan Kumar and Rahul Khanna
World Journal of Surgical Medical and Radiation Oncology 2012, 1:2
Introduction: Primary lymphoma of the thyroid accounts for 5% of all thyroid malignancies . It differs greatly from other thyroid neoplasms with regards to the diagnostic and therapeutic approach.
Patients and Methods: We treated 12 patients with thyroid lymphoma over a 10 years period. The commonest presentation was thyroid mass with associated cervical lymph nodes or subcutaneous nodules. More than half the patients had hypothyroidism which was subclinical and detected on hormonal assay. The commonest histological variant was non Hodgkin’s lymphoma of B-cell origin followed by Mucosa Associated Lymphoid Tissue (MALT) cell lymphoma. The main stay of treatment was surgery with adjuvant chemotherapy. At 3 years follow-up 9 patients (75%) were recurrence free.
Discussion: Lymphoma of the thyroid develops in a background of Hashimoto’s disease or chronic lymphocytic thyroiditis. Most patients have associated subclinical hypothyroidism. Fine Needle Aspiration Cytology (FNAC) is of limited help in diagnosis as it may not distinguish thyroid lymphoma from chronic lymphocytic thyroiditis or a follicular neoplasm. Histologically it is usually non Hodgkin’s lymphoma of B cell variety although 10% cases may be of MALT cell origin. Chemotherapy is the sheet anchor of treatment with surgery and/or radiotherapy playing an adjuvant role. Prognosis is usually excellent and 100% survival at 5 years have been reported.