Hadzić B, Budakov P, Stajnic S
Med Pregl. 1989;42(9-10):355-7.
Primary malignant lymphoma of extranodal localization is a rare disease which mainly occurs in organs with greater or less quantity of lymphocytic tissue or in the organs with the previous history of lymphocytic infiltrate. Extranodal localization of malignant lymphoma in the thyroid gland is rare and numerous authors associate it with the previous existence of chronic lymphocatic thyroiditis (Hashimoto struma). This paper dealt with the histologically analysed material obtained by subtotal or total thyreoidectomy over one-year period. Out of 49 cases, histologic diagnosis of chronic diffuse lymphocytic thyroiditis was established in nine patients (18%) but the frequency of the appearance of this autoimmune disease may well be grater because a relatively small number of patients underwent the operation. Apart from all morphologic characteristics of Hashimoto struma, primary malignant lymphoma of extranodal localization in the thyroid gland was diagnosed in one patient. Simultaneous or previous evolution of chronic lymphocyttic thyroiditis into malignant lymphoma was confirmed in the papers of numerous authors. The authors presented a patient aged 58 in whom malignant lymphoma had evolved from the chronic diffuse lymphocytic thyroiditis. Cellular characteristics pointed to lymphoma of transformed cells being extended extrathyroidically into the surrounding connecting and muscular tissue with the involvement of regional lymph glands. Of particular importance was the area in which the usual architectonics of lymphocytic thyroiditis was discretely ruined and the infiltrate received neoplastic characteristics. On the basis of data from literature, lymphocytic thyroiditis should be regarded as a prelymphomatous state which was attached a great importance from the aspect of histopathologic analysis. Beside the operation, conservative therapy was employed and it showed good results until now, although it was too early to make decisive conclusions on the outcome of disease.
结外原发性恶性淋巴瘤是一种罕见疾病，主要发生于淋巴细胞组织或多或少的器官，或有淋巴细胞浸润病史的器官。甲状腺的恶性淋巴瘤结外定位罕见，许多作者将其与既往存在的慢性淋巴细胞性甲状腺炎（桥本甲状腺肿）相关联。本文探讨了在一年时间内通过甲状腺次全切除术或全切除术获得的经组织学分析的材料。49例患者中，9例（18%）确诊为慢性弥漫性淋巴细胞性甲状腺炎，但由于接受手术的患者数量相对较少，这种自身免疫性疾病的出现频率可能更高。除了桥本甲状腺肿的所有形态学特征外，1例患者被诊断为甲状腺结外原发性恶性淋巴瘤。众多作者的论文证实了慢性淋巴细胞性甲状腺炎同时或先前演变为恶性淋巴瘤。作者介绍了一名58岁患者，其恶性淋巴瘤由慢性弥漫性淋巴细胞性甲状腺炎演变而来。细胞特征表明转化细胞淋巴瘤已甲状腺外扩展至周围结缔组织和肌肉组织，并累及区域淋巴结。特别重要的是淋巴细胞性甲状腺炎的正常结构被离散破坏且浸润具有肿瘤特征的区域。根据文献数据，淋巴细胞性甲状腺炎应被视为一种淋巴瘤前期状态，从组织病理学分析角度来看具有重要意义。除手术外，采用了保守治疗，目前显示出良好效果，尽管就疾病结局做出决定性结论还为时过早。
