Thyroid lymphoproliferative lesions in Asia.

Area of Science:

• Oncology
• Pathology
• Internal Medicine

Background:

• Primary thyroid lymphomas (PTLs) are rare malignancies.
• PTLs often present as rapidly enlarging thyroid masses causing obstructive symptoms.
• Clinical practices for thyroid malignancy diagnosis vary globally.

Purpose of the Study:

• To compare clinicopathological features and diagnostic modalities of PTLs.
• To identify similarities and differences in PTL presentation between Asian and Western countries.

Main Methods:

• Systematic review of published data on PTLs using PubMed.
• Inclusion of 18 Asian and 22 Western studies.
• Analysis of histological types, disease stage, diagnostic methods (USG, FNAC, biopsy), and ancillary techniques (ICC, FC, IHC, molecular testing).

Main Results:

• Most PTLs are B-cell Non-Hodgkin lymphomas (NHL).
• Mucosa-associated lymphoid tissue (MALT) lymphoma is common in Asians (41.1%), while diffuse large B cell lymphoma (DLBCL) predominates in Western populations (71.9%).
• Western patients had a higher proportion of advanced stage (III/IV) disease compared to Asian patients (12.2% vs. 3%).
• Ancillary diagnostic techniques are more frequently used in the West, improving diagnostic sensitivity.

Conclusions:

• Apparent differences exist in PTL histological type and stage of presentation between Asian and Western cohorts.
• Publication and selection bias may influence these findings.
• Advanced ancillary techniques are more prevalent in Western diagnostic practices for PTL.