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Primary Thyroid Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma: A Case Report
Nuno Gonçalves1, Cristina Monteiro1, Luísa Calais Pereira1
1General Surgery, Unidade Local de Saúde do Alto Minho, Viana do Castelo, PRT.
Cureus
|June 10, 2025
Summary
This case study highlights a rare diagnosis of primary thyroid mucosa-associated lymphoid tissue (MALT) lymphoma, often missed due to subtle symptoms. Early consideration in patients with thyroiditis and new nodules is crucial for timely diagnosis and treatment.
Area of Science:
- Endocrinology
- Oncology
- Pathology
Background:
- Primary thyroid lymphoma (PTL) is rare, with mucosa-associated lymphoid tissue (MALT) lymphoma being an infrequent subtype.
- MALT lymphoma of the thyroid is often associated with chronic lymphocytic thyroiditis and can present indolently, delaying diagnosis.
Observation:
- A 63-year-old woman with autoimmune hypothyroidism presented with a rapidly enlarging neck mass and compressive symptoms.
- Initial ultrasound showed a heterogeneous thyroid gland with a lesion suspicious for focal thyroiditis, and fine-needle aspiration was non-diagnostic for malignancy (Bethesda II).
Findings:
- Histopathological and immunohistochemical analyses following total thyroidectomy confirmed primary MALT lymphoma of the thyroid.
- This case underscores the challenge of diagnosing MALT lymphoma due to its rarity and potential for mimicking benign thyroid conditions.
Implications:
- Primary MALT lymphoma of the thyroid should be considered in patients with chronic thyroiditis experiencing new or enlarging nodules.
- Surgical excision can be both diagnostic and therapeutic for localized disease.
- Postoperative surveillance is vital to monitor for potential systemic involvement.
