Lymphoma of the thyroid. An unusual clinical course in a patient possessing a 14/21 translocation

The unusual course of a lymphoma in a woman with a chromosome abnormality is reported. When aged 30 years, the right lobe of her thyroid gland was found to be infiltrated by a follicular lymphoma. Two years later, poorly differentiated diffuse lymphoctic lymphoma recurred locally, grew rapidly, and infiltrated the adjoining muscles. It was treated by widefield irradiation of the upper trunk and neck, and disappeared completely. The patient remained sympton-free for 22 years. Unequivocal Hodgkin's disease then developed in a left cervical lymph node; the patient received radiotherapy. Eighteen months later the right inguinal nodes were infiltrated by similar tumor and further treatment was given. Massive abdominal involvement followed and the patient died 28 years after developing the thyroid lymphoma. The tumor at necropsy was pleomorphic and contained Reed-Sternberg cells. The significance of the constitutional chromosome abnormality, a Robertsonian translocation of the No. 14 chromosome, is discussed.