Coşkun Halil, Bozbora Alp, Kapran Yersu, Erbil Yeşim, Ozarmağan Selçuk
Department of General Surgery, Medicine Faculty of Istanbul University, Istanbul, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2004;12(1-2):11-5.
We investigated the incidence of primary thyroid lymphoma in thyroid malignancies.
A total of 304 patients whose diagnoses were made as thyroid malignancies between January 1990 and December 2000 were retrospectively evaluated. Of these, primary thyroid lymphoma was documented in four female patients (1.3%; mean age 56.2 years; range 40 to 65 years). Findings from history, physical examination, blood biochemistry, thyroid hormone levels (T3, T4, TSH, thyroglobulin), thyroid scintigraphy, fine-needle aspiration biopsy, and cervical computed tomography (CT) were evaluated. Histopathologic results were evaluated according to the Revised European-American Lymphoma (REAL) classification.
The most common complaints on admission were a rapidly growing cervical mass, hoarseness, and dyspnea. In all the cases, thyroid hormone levels were normal, but thyroglobulin levels were 5 to 10 times as high as normal. Preoperative fine-needle aspiration was not helpful in two cases, whereas cervical CT was diagnostic. Pathologic diagnosis was diffuse large B cell lymphoma in all the cases. Postoperatively, three cases underwent chemotherapy and one case chemotherapy combined with radiotherapy. All the patients were operated on before 1997; one patient died, the remaining three patients have been under follow-up with no recurrences.
In our cases, treatment of localized thyroid lymphoma by surgery combined with chemotherapy or/and radiotherapy was effective.
我们调查了原发性甲状腺淋巴瘤在甲状腺恶性肿瘤中的发病率。
回顾性评估了1990年1月至2000年12月期间诊断为甲状腺恶性肿瘤的304例患者。其中，4例女性患者被诊断为原发性甲状腺淋巴瘤（1.3%；平均年龄56.2岁；范围40至65岁）。对病史、体格检查、血液生化、甲状腺激素水平（T3、T4、TSH、甲状腺球蛋白）、甲状腺闪烁扫描、细针穿刺活检以及颈部计算机断层扫描（CT）的结果进行了评估。组织病理学结果根据修订的欧美淋巴瘤（REAL）分类进行评估。
入院时最常见的主诉是颈部肿块迅速增大、声音嘶哑和呼吸困难。所有病例中，甲状腺激素水平均正常，但甲状腺球蛋白水平比正常高5至10倍。术前细针穿刺在2例病例中无帮助，而颈部CT具有诊断价值。所有病例的病理诊断均为弥漫性大B细胞淋巴瘤。术后，3例接受了化疗，1例接受了化疗联合放疗。所有患者均在1997年前接受了手术；1例患者死亡，其余3例患者一直在接受随访，无复发。
在我们的病例中，手术联合化疗或/和放疗治疗局限性甲状腺淋巴瘤是有效的。
