Thyroid Lymphoma

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Thyroid Lymphoma

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Primary thyroid lymphoma n be defined a lymphoma that arises from the thyroid gland. This definition excludes those that invade the thyroid gland a consequence of either mettis or direct extension. Primary thyroid lymphom are practilly always non-Hodgkin lymphom (NHLs). Primary thyroid Hodgkin lymphoma is extremely rare.

NHLs n be divided into aggressive and indol types. Aggressive NHLs comprise a large number of types, the most common of which is large- lymphoma. They most frequly arise from lymph nodes, but an extranodal site is the primary source in approximately 30% of ces, and the thyroid gland is among the most common of these extranodal sites.

Thyroid NHL repress approximately 1.2 to 1.7% of all NHLs. [1] It is highly curable, without the need for extensive surgery. Accordingly, early recognition and correct treatm of this condition is vital. The most common type is diffuse large- lymphoma, either sociated or unsociated with mucosa-sociated lymphoid tissue (MALT) lymphoma (MALToma).The best treatm results for primary thyroid large- lymphoma are with combined-modality therapy; for primary thyroid MALToma, radiation therapy alone is probably adequate. [2, 3] Primary T- lymphoma of thyroid is extremely rare, accounting for less than 2% of all primary thyroid lymphom, and n pres both diagnostic and therapeutic challenges. [4]

Thyroid lymphom are very frequly sociated with Hhimoto thyroiditis (HT). Conversely, there is a markedly ineed incidence of primary thyroid lymphom in patis with HT. [5] Such lesions are an aggressive or high-grade variant, where a low-grade MALT is an indol type.

Like other low-grade MALTom, such those presing in the parotid in sociation with Sjögren syndrome, those arising in the thyroid also occur in sociation with an autoimmune disorder (in this ce, HT). The hypothesis is that chronic antnic stimulation secondary to the autoimmune disorder leads to chronic proliferation of lymphoid tissue, which evually undergoes a mutation that leads to the developm of lymphoma.

Primary thyroid lymphoma is rare, constituting only 1-2% of all extranodal lymphom and approximately 2-8% of all thyroid malignancies. [6, 5, 7, 8] with other non-Hodgkin lymphom, the median age of presation in patis with thyroid lymphoma is usually close to 60 years. [8, 7] Most ces occur in women.

The prognosis for patis with thyroid large- lymphoma usually is favorable beuse they typilly pres with lolized disee, which is amenable to treatm with chemotherapy and radiation. The cure rate is typilly high (see Treatment). A large population-bed study that evaluated prognostic factors found that older age, advanced stage, histologic subtype, and lack of radiation/surgil treatm were adverse factors for suival. [9]

A rare ce of pulmonary mettis h been reported in a 65-year-old woman diagnosed with a primary thyroid MALToma who underw total thyroidectomy, followed by chemotherapy. After 5 years of follow-up, she w diagnosed with mettatic thyroid MALT lymphoma. [10]

Holm LE, Blomgren H, Lowhagen T. ncer risks in patis with chronic lymphocytic thyroiditis. N Engl J Med. 1985 Mar 7. 312(10):601-4. [Medline].

Isaacson PG. Lymphoma of the thyroid gland. Curr Top Pathol. 1997. 91:1-14. [Medline].

Laing RW, Hoskin P, Hudson BV, et al. The signifince of MALT histology in thyroid lymphoma: a review of patis from the BNLI and Royal Marsden Hospital. Clin Oncol (R Coll Radiol). 1994. 6(5):300-4. [Medline].

Mishra P, Banerjee D, Gujral S. T- Lymphoma of Thyroid Gland with Lennert Type of Morphology: A Ce Report and Review of the Literature. Head Neck Pathol. 2016 Sep. 10 (3):321-6. [Medline].

Ansell SM, Grant CS, Habermann TM. Primary thyroid lymphoma. Semin Oncol. 1999 Jun. 26(3):316-23. [Medline].

Peppa M, Nikolopoulos P, Korkolopoulou P, Lapatsanis D, Dimitriadis G, Hadjidakis D, et al. Primary mucosa-sociated lymphoid tissue thyroid lymphoma: a rare thyroid neoplm of extrathyroid origin. Rare Tumors. 2012 Jan 2. 4(1):e2. [Medline]. [Full Text].

Tupchong L, Hughes F, Harmer CL. Primary lymphoma of the thyroid: clinil features, prognostic factors, and results of treatm. Int J Radiat Oncol Biol Phys. 1986 Oct. 12(10):1813-21. [Medline].

Pieka JL. Anapltic ncer, lymphoma, and mettes of the thyroid gland. Surg Oncol Clin N Am. 1998 Oct. 7(4):707-20. [Medline].

Graff-Baker A, Sosa JA, Roman SA. Primary thyroid lymphoma: a review of rec developms in diagnosis and histology-driven treatm. Curr Opin Oncol. 2010 Jan. 22(1):17-22. [Medline].

Satoh K, Morita T, Fumimoto S, Tsuji H, Ichihhi Y, Ochi K, et al. Rare Pulmonary Mettis From Thyroid Mucosa-sociated Lymphoid Tissue Lymphoma. Ann Thorac Surg. 2015 Aug. 100 (2):700-2. [Medline].

Pappa VI, Hussain HK, Reznek RH, et al. Role of image-guided core-needle biopsy in the managem of patis with lymphoma. J Clin Oncol. 1996 Sep. 14(9):2427-30. [Medline].

Ha CS, Shadle KM, Medeiros LJ, et al. Lolized non-Hodgkin lymphoma involving the thyroid gland. ncer. 2001 Feb 15. 91(4):629-35. [Medline].

Watanabe N, Noh JY, Narimatsu H, et al. Clinicopathologil features of 171 ces of primary thyroid lymphoma: a long-term study involving 24 553 patis with Hhimoto’s disee. Br J Haematol. 2011 Mar 4. [Medline].

International Non-Hodgkin Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin”s lymphoma. The International Non-Hodgkin”s Lymphoma Prognostic Factors Project. N Engl J Med. 1993 Sep 30. 329(14):987-94. [Medline].

Matsuza F, Miyauchi A, Katayama S, et al. Clinil pects of primary thyroid lymphoma: diagnosis and treatm bed on our experience of 119 ces. Thyroid. 1993 Summer. 3(2):93-9. [Medline].

TP, Dahlberg S, Csidy JR, et al. Three cycles of CHOP (CHOP-3) plus radiotherapy (RT) is superior to eight cycles of CHOP (CHOP-8) alone for lolized intermediate grade non-Hodgkin’s lymphoma (NHL). A Southwest Oncology Group study. Proc Ann Meet Am Soc Clin Oncol. 1996. 15 (A1257):411.

Coiffier B, Thieblemont C, Van Den Neste E, Lepeu G, Plantier I, Ctaigne S, et al. Long-term outcome of patis in the LNH-98.5 trial, the first randomized study comparing rituximab-CHOP to standard CHOP chemotherapy in DLBCL patis: a study by the Groupe d’Etudes des Lymphomes de l’Adulte. Blood. 2010 Sep 23. 116(12):2040-5. [Medline]. [Full Text].

Rodriguez J, banill F, McLaughlin P, et al. A proposal for a simple staging system for intermediate grade lymphoma and immunobltic lymphoma bed on the ”tumor score”. Ann Oncol. 1992 Nov. 3(9):711-7. [Medline].

Fernando banill, MD Professor of Medicine, University of Puerto Rico School of Medicine; Adjunct Professor of Medicine, MD Anderson ncer Cer, University of Tex Medil School at Houston; Adjunct Professor, Moffitt ncer Cer; Medil Director, Auxilio Mutuo ncer Cer, Puerto Rico

Fernando banill, MD is a member of the following medil societies: Alpha Omega Alpha, American Association for the Advancement of Science, American Association for Cancer Research, American College of Physicians-American Society of Internal Medicine, American Society of Hematology, New York Academy of Sciences, Texas Medical Association

Disclosure: Nothing to disclose.

Emmanuel C Besa, MD Professor Emeritus, Departm of Medicine, Division of Hematologic Malignancies and Hematopoietic Stem Transplantation, Kimmel ncer Cer, Jefferson Medil College of Thom Jefferson University

Emmanuel C Besa, MD is a member of the following medil societies: American Association for Cancer Education, American Society of Clinical Oncology, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Hematology, New York Academy of Sciences

Disclosure: Nothing to disclose.

Lodovico Balducci, MD Professor of Oncology and Medicine, University of South Florida College of Medicine; Division Chief, Senior Adult Oncology Program, H Lee Moffitt ncer Cer and Research Institute

Disclosure: Nothing to disclose.

Wendy Hu, MD Consulting Staff, Departm of Hematology/Oncology and Bone Marrow Transplantation, Huntington Memorial Medil Cer

Wendy Hu, MD is a member of the following medil societies: American Association for the Advancement of Science, American College of Physicians, American Society for Blood and Marrow Transplantation, American Society of Hematology, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct sistant Professor, University of Nebrka Medil Cer College of Pharmacy; Editor-in-Chief, Medspe Drug Reference

Disclosure: Medspe Salary loym

Thyroid Lymphoma


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