Non-Hodgkin's lymphoma presenting as thyroid enlargement.

From 1969 to 1978, 11 patients with non-Hodgkin's lymphoma presenting as thyroid enlargement were evaluated and treated in the Division of Radiation Therapy at Stanford University Hospital. All patients were staged with lymphangiogram and bone marrow biopsy. Eight patients had Stage I-II disease and three patients had Stage III-IV disease. The histologic pattern of the biopsies was diffuse in nine cases, and eight cases were classified as histiocytic lymphoma. All eight patients with Stage I or II disease were treated with irradiation. There is an 83.3% survival at three years and a 75% relapse-free survival at two years. No instance of local recurrence was observed in this group of patients. The three patients with Stage III or IV disease were treated by either irradiation or chemotherapy. Two relapsed within one year and died with disease; the third remained free of disease for nine years before relapse and died with disease six months later. High dose regional irradiation is the recommended treatment for patients with Stage I-II lymphoma of the thyroid.