Struma lymphomatosa and carcinoma of the thyroid

In patients with struma lymphomatosa treated by feeding thyroid, the indicence of lymphomas is low, and the prognosis of the patients is relatively good. The risk of thyroidectomy on all patients with uncomplicated struma lymphomatosa would greatly outweigh the benefits of preventing carcinoma. The association between struma lymphomatosa and carcinoma of thyroid does not appear to be causal. When patients are fed thyroid, there is little or no tendency for struma lymphomatosa to progress to clinically detectable carcinoma of the thyroid. The association of struma and papillary carcinoma comes from the observation of lymphocytic infiltration of the tissues surrounding papillary carcinomas of the thyroid, the result either of a lymphocytic reaction to the carcinoma or to radiation rather than that the carcinoma arose as a result of lymphocytic thyroiditis. Observation of 373 patients with struma lymphomatosa diagnosed by needle biopsy and treated by feeding thyroid failed to reveal a single instance of carconoma of the thyroid in 3,000 patient years of observation. In patients with uncomplicated struma lymphomatosa, the possibility of malignant tumor does not provide an indication either for open biopsy or for thyroidectomy.