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T-cell lymphoma in Hashimoto's thyroiditis
Z H Abdul-Rahman1, H J Gogas, J A Tooze
1Department of Histopathology, St George's Hospital, London, UK.
Histopathology
|November 1, 1996
Summary
A rare T-cell lymphoma of the thyroid was identified in a patient without HTLV-1 exposure. This case highlights unusual features of primary thyroid T-cell lymphoma, including its presentation and immunophenotype.
Area of Science:
- Oncology
- Immunology
- Pathology
Background:
- Primary thyroid lymphomas are rare, with B-cell lymphomas (MALT-associated) being more recognized than T-cell lymphomas.
- Peripheral T-cell lymphomas (PTCLs) are uncommon in the thyroid, particularly in non-endemic regions for human T-lymphotropic virus type 1 (HTLV-1).
Observation:
- An elderly Caucasian woman with hypothyroidism presented with a rapidly growing thyroid mass.
- The tumor exhibited morphological and immunological features of PTCL, with an immunophenotype resembling HTLV-1-associated adult T-cell leukemia/lymphoma.
- Despite the immunophenotype, the patient was serologically negative for HTLV-1 and had no history of travel to endemic areas.
Findings:
- Monoclonal gene rearrangements confirmed a T-cell origin using T-cell receptor beta- and gamma-specific primers.
- The thyroid gland showed features consistent with Hashimoto's thyroiditis.
- The lymphoma presented at an early clinical stage (IE), contrasting with more advanced stages typically reported for thyroid T-cell lymphoma.
Implications:
- This case underscores the rarity of primary thyroid T-cell lymphomas and challenges typical associations with HTLV-1.
- The findings suggest that thyroid T-cell lymphomas can occur in individuals without HTLV-1 exposure and may present with an immunophenotype mimicking the virus-associated form.
- Further research is needed to understand the pathogenesis and clinical behavior of these rare thyroid malignancies.