Features of Thyroid Lymphoma: A Single-Center Experience

Area of Science:

• Endocrinology
• Oncology
• Pathology

Background:

• Primary thyroid lymphoma (PTL) is a rare malignancy, comprising <5% of thyroid cancers.
• PTL predominantly affects older women and is linked to autoimmune thyroiditis, especially Hashimoto's thyroiditis.
• Diagnosis is challenging due to non-specific findings, shifting surgery's role to diagnostic.

Purpose of the Study:

• To analyze the clinical presentation, diagnosis, and treatment outcomes of PTL.
• To evaluate the diagnostic utility of fine-needle aspiration cytology (FNAC) and surgical biopsy in PTL.
• To highlight the importance of a multidisciplinary approach in managing PTL.

Main Methods:

• Retrospective single-center case series of nine PTL patients (2015-2025).
• Analysis of clinical data, pre-existing thyroid disease, diagnostic work-up (ultrasound, FNAC), histopathology, and treatment outcomes.
• Surgical intervention was used to confirm cytology, when inconclusive, or for compressive symptoms.

Main Results:

• The cohort (6 female, 3 male, median age 65.2) included patients with Hashimoto's thyroiditis and multinodular goiter.
• FNAC was diagnostic in only 3 cases; 8 patients required surgical biopsy/thyroidectomy for definitive diagnosis.
• Seven patients received chemoimmunotherapy, achieving complete response in eight; subtypes included DLBCL, Burkitt's, Hodgkin's, follicular, high-grade B-cell, and MALT lymphoma.

Conclusions:

• PTL is a rare, diagnostically challenging thyroid malignancy.
• FNAC is often insufficient; surgical biopsy is vital for high clinical suspicion or compressive symptoms.
• A multidisciplinary approach and tailored treatment are crucial for favorable PTL outcomes, despite limited surgical therapeutic value.