[The role of surgery in the management of thyroid lymphoma].

OBJECTIVE

To evaluate the role of surgery in the management of thyroid lymphoma.

METHODS

A retrospective analysis was performed of 14 patients with thyroid lymphoma treated at the Cancer Hospital, Peking Union Medical College, Chinese Academy Medical Science from 1964 to March 1998. There were 5 males and 9 females, with a median age of 54 years (range 15-75). There were 4 cases in stage IEA, 9 in stage IIEA, 1 in stage II EB. Fine needle aspiration biopsy was performed in 1 case, excision biopsy in 4, thyroid lobectomy in 8, and total thyroidectomy in 1. Radiotherapy was used alone in 4 patients, chemotherapy alone in 2, radiotherapy combined with chemotherapy in 7, no postoperative treatment in 1.

RESULTS

All but 1 patients were histopathologically diagnosed as non-Hodgkin's lymphoma. It was of B cell origin in 11 cases, T cell origin in 2. Seven patients were alive without evidence of recurrent disease at follow-up, ranging from 5 to 112 months. Three patients died of lymphoma, 1 died of treatment complication, 2 died of other diseases, and 1 lost from follow-up. The major surgical resection did not appreciably affect survival.

CONCLUSION

Radiotherapy or chemotherapy, alone or in combination, is the treatment of choice for thyroid lymphoma. Surgical resection combined with radiotherapy or chemotherapy may be beneficial to survival in patients with intrathyroid lymphoma. It is otherwise limited to make a tissue diagnosis.