Shen Guohua, Ji Ting, Hu Shuang, Liu Bin, Kuang Anren
From the Department of Nuclear Medicine, West China Hospital of Sichuan University, No.37, Guoxue Alley, Chengdu, Sichuan (GS, SH, BL, AK); and Department of Nuclear Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, Yan Ta Road, Xi'an, Shanxi, People's Republic of China (TJ).
Medicine (Baltimore). 2015 Dec;94(52):e2403. doi: 10.1097/MD.0000000000002403.
Papillary thyroid carcinoma (PTC) is the most common type of thyroid neoplasias; however, primary thyroid gland lymphoma (PTL) is uncommon and their simultaneous occurrence is very rare.Herein, we reported a 25-year-old female patient with Hashimoto's thyroiditis (HT), who developed a small goiter with a palpable 1.2-cm nodule in the right lobe. A fine-needle aspiration (FNA) biopsy revealed atypical follicular epithelial cells and lymphoid cells in a background of lymphocytic thyroiditis. A total thyroidectomy was performed. The pathology showed multicentric papillary thyroid carcinoma, concomitant thyroid mucosa-associated lymphoid tissue (MALT) lymphoma, and Hashimoto's thyroiditis. Postoperatively, he received chemotherapy and radioactive iodine ablation treatment. Nowadays the thyroglobulin of the patient is undetectable, without recurrences at 2 years of follow-up.It is concluded that the PTC and MALT lymphoma can exist concomitantly, especially in patients with HT. For the diagnostic workup and optional management of this rare coexistence, a multidisciplinary approach and close surveillance are needed.
乳头状甲状腺癌（PTC）是最常见的甲状腺肿瘤类型；然而，原发性甲状腺淋巴瘤（PTL）并不常见，二者同时发生则极为罕见。在此，我们报告了一名25岁患有桥本甲状腺炎（HT）的女性患者，其右侧叶出现一个可触及的1.2厘米小结节的小甲状腺肿。细针穿刺（FNA）活检显示在淋巴细胞性甲状腺炎背景下存在非典型滤泡上皮细胞和淋巴细胞。进行了全甲状腺切除术。病理显示多中心乳头状甲状腺癌、伴发的甲状腺黏膜相关淋巴组织（MALT）淋巴瘤以及桥本甲状腺炎。术后，她接受了化疗和放射性碘消融治疗。目前患者的甲状腺球蛋白检测不到，随访2年无复发。结论是PTC和MALT淋巴瘤可同时存在，尤其是在HT患者中。对于这种罕见共存情况的诊断检查和可选治疗，需要多学科方法和密切监测。
