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原发性甲状腺淋巴瘤:病例系列

Primary Thyroid Lymphoma: A Case Series.

作者信息

Alalawi Yousef, Alrashidi Tahani N, Shafie Sarah, Moharram Laila, Asiri Abeer

机构信息

Department of Surgery, King Salman Armed Forces Hospital, Tabuk, SAU.

Department of Histopathology, King Salman Armed Forces Hospital, Tabuk, SAU.

出版信息

Cureus. 2025 Aug 1;17(8):e89197. doi: 10.7759/cureus.89197. eCollection 2025 Aug.

DOI:10.7759/cureus.89197
PMID:40901213
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12400473/
Abstract

Background Primary thyroid lymphoma (PTL) is a rare form of thyroid cancer. It is frequently accompanied by Hashimoto's thyroiditis. Treatment approaches differ significantly from those used for other types of thyroid cancer. This study aimed to examine the clinical presentation, diagnostic methods, and treatment strategies employed in patients with PTL. Materials and methods We present a retrospective case series of seven patients diagnosed with PTL at a tertiary care hospital between 2017 and 2021. Results Our sample included seven patients, five (71.4%) females and two (28.6%) males. The mean age was 57.8, and their ages ranged from 39 to 77. Four of our patients were diagnosed with Hashimoto's thyroiditis. Most of the patients presented with a rapidly enlarging mass associated with compression symptoms. The diagnosis of PTL was made by core needle biopsy and surgical excision. They all had diffuse large B-cell lymphoma (DLBCL) in the histopathological examination. Out of the total patients, 28.6% (two patients) experienced mortality: one in stage III and one in stage IV. Conclusion Any patient presenting with a rapidly growing thyroid mass accompanied by a history of Hashimoto's thyroiditis should raise the possibility of PTL. In our retrospective case series, DLBCL was identified as the predominant subtype. Fine-needle aspiration cytology (FNAC) demonstrated limited diagnostic modalities, with none of the cases achieving a definitive diagnosis. In contrast, core needle biopsy was the preferred diagnostic tool. Surgery plays a limited role and is mainly for diagnosis. Prognosis depends on the stage of the disease at diagnosis.

摘要

背景 原发性甲状腺淋巴瘤(PTL)是一种罕见的甲状腺癌形式。它常伴有桥本甲状腺炎。其治疗方法与其他类型的甲状腺癌有显著差异。本研究旨在探讨PTL患者的临床表现、诊断方法和治疗策略。

材料与方法 我们回顾性分析了2017年至2021年在一家三级医疗中心确诊为PTL的7例患者的病例系列。

结果 我们的样本包括7例患者,5例(71.4%)为女性,2例(28.6%)为男性。平均年龄为57.8岁,年龄范围为39至77岁。我们的4例患者被诊断为桥本甲状腺炎。大多数患者表现为迅速增大的肿块并伴有压迫症状。PTL通过粗针活检和手术切除确诊。组织病理学检查显示他们均为弥漫性大B细胞淋巴瘤(DLBCL)。在所有患者中,28.6%(2例患者)死亡:1例为III期,1例为IV期。

结论 任何出现甲状腺肿块迅速增大且伴有桥本甲状腺炎病史的患者都应考虑PTL的可能性。在我们的回顾性病例系列中,DLBCL被确定为主要亚型。细针穿刺细胞学检查(FNAC)显示诊断方式有限,所有病例均未明确诊断。相比之下,粗针活检是首选的诊断工具。手术作用有限,主要用于诊断。预后取决于诊断时疾病的分期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30cd/12400473/c257d5cc8aab/cureus-0017-00000089197-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30cd/12400473/697ab6253967/cureus-0017-00000089197-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30cd/12400473/c257d5cc8aab/cureus-0017-00000089197-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30cd/12400473/697ab6253967/cureus-0017-00000089197-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30cd/12400473/c257d5cc8aab/cureus-0017-00000089197-i02.jpg

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本文引用的文献

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Effectiveness of core needle biopsy in the diagnosis of thyroid lymphoma and anaplastic thyroid carcinoma: A systematic review and meta-analysis.甲状腺淋巴瘤和间变性甲状腺癌的核心针活检诊断的有效性:系统评价和荟萃分析。
Front Endocrinol (Lausanne). 2022 Sep 20;13:971249. doi: 10.3389/fendo.2022.971249. eCollection 2022.
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Diagnostic performance of ultrasound and computed tomography in parallel for the diagnosis of lymph node metastasis in patients with thyroid cancer: a systematic review and meta-analysis.超声与计算机断层扫描并行诊断甲状腺癌患者淋巴结转移的诊断性能:一项系统评价和荟萃分析
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Is it Anaplastic Thyroid Cancer, Primary Thyroid Lymphoma, or Rosai Dorfman Disease? An Elusive Histopathologic Diagnosis of a Thyroid Mass.是间变性甲状腺癌、原发性甲状腺淋巴瘤,还是罗斯氏滤泡树突细胞瘤?甲状腺肿块的一种难以明确的组织病理学诊断。
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