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Primary thyroid diffuse large B-cell lymphoma coexistent with papillary thyroid carcinoma: A case report.
Shumin Xie1, Wei Liu1, Yuyan Xiang2
1Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital of Central South University, Changsha, People's Republic of China.
Head & Neck
|October 30, 2014
Summary
This case report details a rare instance of coexisting primary thyroid lymphoma (PTL) and papillary thyroid carcinoma (PTC). Early recognition of PTL is crucial for accurate diagnosis and treatment of thyroid malignancies.
Area of Science:
- Endocrinology
- Oncology
- Pathology
Background:
- Primary thyroid lymphoma (PTL) is a rare malignancy, comprising 2-5% of all thyroid cancers.
- Papillary thyroid carcinoma (PTC) is the most common thyroid cancer, but its coexistence with PTL is exceptionally rare.
- Preoperative diagnosis of coexisting PTL and PTC presents significant clinical challenges.
Observation:
- A 41-year-old male presented with rapid, painless thyroid enlargement and a palpable cervical mass.
- Imaging revealed an enlarged thyroid gland with a distinct intralesional mass.
Findings:
- Histopathological and immunohistochemical examination confirmed the simultaneous presence of PTL and PTC.
- The patient received cyclophosphamide, hydroxy doxorubicin, oncovin, prednisone (CHOP) chemotherapy and radiotherapy.
- Post-treatment follow-up at 2 months showed no evidence of recurrence or metastasis.
Implications:
- This case underscores the necessity of considering PTL in the differential diagnosis of patients presenting with sudden thyroid enlargement.
- Physicians should maintain a high index of suspicion for PTL, particularly in patients with a history of Hashimoto thyroiditis.
- Accurate preoperative diagnosis is vital for appropriate management of these rare coexisting thyroid conditions.
