Rasbach D A, Mondschein M S, Harris N L, Kaufman D S, Wang C A
Surgery. 1985 Dec;98(6):1166-70.
Among 20 patients with malignant lymphoma of the thyroid gland, the mean age at diagnosis was 63 years and the male to female ratio was 1:6. All patients had a firm, rapidly enlarging neck mass. In 90% of the patients the mass had been present for less than 1 year; in 40%, for less than 1 month. Approximately half of the patients tested had hypothyroidism; three fourths had elevated antithyroid antibodies. There was one nodular lymphoma. The remaining 17 cases available for review were diffuse. Thyroid lobectomy was performed in seven patients, limited excision in eight, and needle biopsy alone in five. External irradiation was administered in 11 cases (55%). Chemotherapy was used alone in one patient (5%) and in combination with radiotherapy in eight (40%). Six patients (30%) were alive without evidence of recurrent disease at follow-up ranging from 1 to 12 years. Eleven patients had died of lymphoma, all but one dying within 1 year. One patient died of other causes and two were lost to follow-up study. There was no appreciable effect of patient age or sex, lymphoma histology, or extent of surgical resection on survival. Treatment of choice for primary lymphoma of the thyroid gland appears to be external irradiation or chemotherapy, alone or in combination. The role of surgery is limited to making a tissue diagnosis of lymphoma, unless the tumor is completely intrathyroidal.
在20例甲状腺恶性淋巴瘤患者中，确诊时的平均年龄为63岁，男女比例为1:6。所有患者均有一个质地坚硬、迅速增大的颈部肿块。90%的患者肿块出现时间不到1年；40%的患者不到1个月。约一半接受检测的患者存在甲状腺功能减退；四分之三的患者抗甲状腺抗体升高。有1例结节性淋巴瘤。其余17例可供复查的病例为弥漫性。7例患者接受了甲状腺叶切除术，8例进行了局限性切除，5例仅接受了针吸活检。11例患者（55%）接受了外照射。1例患者（5%）单独使用了化疗，8例患者（40%）化疗与放疗联合使用。6例患者（30%）在1至12年的随访中存活，无复发疾病迹象。11例患者死于淋巴瘤，除1例外在1年内死亡。1例患者死于其他原因，2例失访。患者年龄或性别、淋巴瘤组织学类型或手术切除范围对生存无明显影响。甲状腺原发性淋巴瘤的首选治疗方法似乎是单独或联合使用外照射或化疗。手术的作用仅限于对淋巴瘤进行组织诊断，除非肿瘤完全位于甲状腺内。
