Case Western Reserve University School of Medicine, 9501 Euclid Ave, Cleveland, OH, 44106, USA; Department of Surgery, MetroHealth Medical Center, 2500 MetroHealth Dr, Cleveland, OH, 44109, USA.
Department of Endocrine Surgery, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
Am J Surg. 2024 Nov;237:115927. doi: 10.1016/j.amjsurg.2024.115927. Epub 2024 Aug 22.
Primary thyroid lymphoma (PTL) is rare and diagnosis is challenging.
We conducted a multicenter retrospective study of patients with PTL from 1990 to 2023 to determine method of diagnosis, treatment, and outcomes.
The study cohort included 31 patients with PTL; all had thyroid enlargement; 21 (68 %) had compressive symptoms, 11 (35 %) had hypothyroidism and 3 had (10 %) B symptoms. Diagnosis was established from incisional biopsy in 8 (26 %), needle biopsy in 4 (13 %), excisional lymph node biopsy in 1 (3 %), and thyroidectomy specimens in 18 (58 %). 15 (48 %) patients had Hashimoto thyroiditis. Treatment included chemotherapy in 19 (61 %); surgery alone in 7 (23 %); and radiation alone or with surgery in 5 (16 %) patients. One (3 %) patient recurred, and 4 (13 %) patients died after a median 4.2 years.
Diagnosis of PTL was made in only 13 % of patients preoperatively. There may be opportunity for needle biopsy to facilitate earlier diagnosis and treatment.
原发性甲状腺淋巴瘤（PTL）较为罕见，诊断具有挑战性。
我们对 1990 年至 2023 年间的 PTL 患者进行了一项多中心回顾性研究，以确定诊断、治疗和预后方法。
该研究队列包括 31 例 PTL 患者；所有患者均有甲状腺肿大；21 例（68%）有压迫症状，11 例（35%）有甲状腺功能减退症，3 例（10%）有 B 症状。8 例（26%）通过切开活检、4 例（13%）通过细针活检、1 例（3%）通过切除性淋巴结活检、18 例（58%）通过甲状腺切除术标本确诊。15 例（48%）患者患有桥本甲状腺炎。19 例（61%）患者接受了化疗；7 例（23%）患者仅接受了手术；5 例（16%）患者接受了放疗或联合手术。1 例（3%）患者复发，4 例（13%）患者在中位 4.2 年后死亡。
PTL 患者术前仅 13%得到明确诊断。细针活检可能有机会促进早期诊断和治疗。
