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Thyroid MALT lymphoma in patients with a compressive goiter.
Lisa M Earnest1, David S Cooper, James J Sciubba
1Division of Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Head & Neck
|April 22, 2006
Summary
Primary thyroid MALT lymphoma, a rare malignancy, can present unexpectedly within a compressive goiter. Early suspicion and diagnosis are crucial for effective management and positive patient outcomes.
Area of Science:
- Endocrinology
- Oncology
- Pathology
Background:
- Mucosa-associated lymphoid tissue (MALT) lymphomas are rare thyroid malignancies, comprising less than 1% of primary thyroid cancers.
- These lymphomas often arise in the context of autoimmune thyroiditis and can be diagnostically challenging.
- A high index of suspicion is necessary for early detection in at-risk individuals.
Purpose of the Study:
- To report on three cases of primary MALT lymphoma of the thyroid.
- To highlight the unusual presentation of MALT lymphoma within a compressive goiter.
- To review the diagnostic and therapeutic approaches and outcomes for these rare tumors.
Main Methods:
- Retrospective review of three cases of primary MALT thyroid lymphoma diagnosed between 1996 and 2005 at a single institution.
- Analysis of patient records to identify diagnostic workup, treatment strategies, and patient outcomes.
- Review of preoperative fine-needle aspiration (FNA) and final pathology findings.
Main Results:
- All three patients presented with a compressive goiter.
- One patient underwent preoperative fine-needle aspiration (FNA).
- All patients underwent total thyroidectomy for compressive symptoms, with final pathology confirming MALT lymphoma. Two patients received subsequent radiation therapy. All patients remain disease-free.
Conclusions:
- MALT lymphoma of the thyroid can present unexpectedly as a compressive goiter.
- Total thyroidectomy is effective for symptom relief and diagnosis.
- Multimodality treatment, including surgery and radiation, can lead to favorable outcomes.