Outstanding Combination of Primary Thyroid Lymphoma, Papillary Carcinoma, and Hashimoto's Thyroiditis

CHEST Journal ◽  
2014 ◽  
Vol 145 (3) ◽  
pp. 292A
Author(s):  
Francina Bolanos ◽  
Emmanuel Peña Gomezportugal ◽  
Enrique Guzman del alba ◽  
Patricio Santillán Doherty ◽  
Fortunato Juarez
Keyword(s):  
Papillary Carcinoma ◽  
Hashimoto’S Thyroiditis ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Lymphoma ◽  
Primary Thyroid Lymphoma

scholarly journals Contrast-Enhanced Ultrasound in the Differential Diagnosis of Primary Thyroid Lymphoma and Nodular Hashimoto’s Thyroiditis in a Background of Heterogeneous Parenchyma

2021 ◽  
Vol 10 ◽  
Author(s):  
Lulu Yang ◽  
Haina Zhao ◽  
Yushuang He ◽  
Xianglan Zhu ◽  
Can Yue ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Hashimoto’S Thyroiditis ◽  
Diagnostic Performance ◽  
Roc Curves ◽  
Hashimoto's Thyroiditis ◽  
Imaging Features ◽  
Contrast Enhanced Ultrasound ◽  
Thyroid Lymphoma ◽  
Contrast Enhanced ◽  
Primary Thyroid Lymphoma

ObjectiveTo investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in the differentiation of primary thyroid lymphoma (PTL) and nodular Hashimoto’s thyroiditis (NHT) in patients with background of heterogeneous diffuse Hashimoto’s thyroiditis (HT).MethodsSixty HT patients with 64 thyroid nodules (31 PTL and 33 NHT) who had undergone CEUS examination were included in this study. With histopathological results as the reference, we evaluated the imaging features of each nodule on both conventional ultrasonography (US) and CEUS. Quantitative CEUS parameters including peak intensity (PI), time to peak (TTP), and area under the time–intensity curve (AUC) were gathered in the nodule and background parenchyma. The ratio indexes of theses parameters were calculated by the ratio of the lesion and the corresponding thyroid parenchyma. Logistic regression and receiver operating characteristic (ROC) curves analyses of valuable US indicators were further preformed to evaluate the diagnostic capability of CEUS in discrimination of PTL and NHT.ResultsAmong all the observed US imaging features and CEUS parameters, 10 indicators showed significant differences between PTL and NHT (all P < 0.05). All the significant indicators were ranked according to the odds ratios (ORs). Eight of them were CEUS associated including imaging features of enhancement pattern, degree, homogeneity, and quantification parameters of PI, AUC, ratios of PI, AUC, and TTP, while indicators on conventional US, including vascularity and size ranked the last two with ORs less than 3. The five single CEUS parameters showed good diagnostic performance in diagnosis of PTL with areas under ROC curves of 0.72–0.83 and accuracies of 70.3–75.0%. The combination of CEUS imaging features and the ratios of PI, AUC, and TTP demonstrated excellent diagnostic efficiency and achieved area under ROC curve of 0.92, which was significantly higher than any of the five single parameters (all P < 0.05), with a sensitivity of 83.9%, specificity of 87.9%, and accuracy of 85.9%.ConclusionsCEUS is an efficient diagnostic tool in the differential diagnosis of PTL and NHT for patients with diffuse HT. Conjoint analysis of CEUS imaging features and quantification parameters could improve the diagnostic values.

Association of Hashimoto’s Thyroiditis and Burkitt Lymphoma: A Rare Condition to Be Considered

Praxis ◽  
2021 ◽  
Vol 110 (14) ◽  
pp. 812-815
Author(s):  
Dea Degabriel ◽  
Alberto Cerutti ◽  
Laura Caramanica ◽  
Alessandro Viganò ◽  
and Tanja Fusi-Schmidhauser
Keyword(s):  
Weight Loss ◽  
Case Report ◽  
Hashimoto’S Thyroiditis ◽  
Rare Condition ◽  
Hashimoto's Thyroiditis ◽  
Low Grade ◽  
Thyroid Lymphoma ◽  
Thyroid Mass ◽  
Primary Thyroid Lymphoma ◽  
Rule Out

Abstract. We present the case of a 72-year-old woman who was diagnosed with Hashimoto’s thyroiditis and who developed a low-grade fever, fatigue, and weight loss that prompted to perform a thyroid biopsy to rule out an underlying primary thyroid lymphoma. This case report offers the opportunity to review the association between Hashimoto’s thyroiditis and primary thyroid lymphoma. Furthermore, it underlines the importance of considering the diagnosis of lymphoma when a thyroid mass is found in patients with an underlying Hashimoto’s disease, as the timely management is essential for survival with this rare thyroid condition.

scholarly journals Hashimoto’s thyroiditis and primary thyroid lymphoma

QJM ◽  
2020 ◽  
Vol 113 (9) ◽  
pp. 691-692
Author(s):  
Y Otsuka ◽  
M Yasuda ◽  
K Tokumasu ◽  
K Hasegawa ◽  
F Otsuka
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Lymphoma ◽  
Primary Thyroid Lymphoma

Coexistence of Differentiated Thyroid Carcinoma With Primary Thyroid Lymphoma in a Background of Hashimoto's Thyroiditis

2011 ◽  
Vol 29 (25) ◽  
pp. e709-e712 ◽  
Author(s):  
Evangeline Vassilatou ◽  
Theofanis Economopoulos ◽  
Marinella Tzanela ◽  
Dimitra Rontogianni ◽  
Petros Karakitsos ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Hashimoto’S Thyroiditis ◽  
Differentiated Thyroid Carcinoma ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Lymphoma ◽  
Primary Thyroid Lymphoma

scholarly journals Primary Thyroid Lymphoma: A Clinicopathologic Study of 9 Cases and Review of the Literature

2021 ◽  
Author(s):  
Wei-wei Wang ◽  
Li-jing Pan ◽  
Shan-wei Liao ◽  
Xiao-cong Zhou
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Previous History ◽  
Treatment Protocol ◽  
Staging System ◽  
Surgical Excision ◽  
Clinicopathological Characteristics ◽  
Good Prognosis ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Lymphoma ◽  
Primary Thyroid Lymphoma

Abstract Background: Primary thyroid lymphoma（PTL）is extremely rare, thus the dilemma of diagnosis and treatment persists and prognosis remain incompletely understood. Materials and methods: The clinicopathological characteristics, treatment outcomes and prognoses of 9 consecutive primary thyroid lymphoma patients were analyzed retrospectively. Data such as age, gender, presence of Hashimoto’s thyroiditis (HT), treatment protocol, pathologic results and survival status were evaluated. Stage was determined according to the Ann Arbor staging system.Results: They were mostly females with female to male ratio of 1.25：1. The 9 patients ranged in age from 15 to 77 years, with a median age of 63 year. Most of them（7/9）were older than 40 year. A previous history of Hashimoto’s thyroiditis (HT) was observed in 4 patients. All of the nine patients were non-Hodgkin lymphoma（NHL）, eight patients were B cell NHL and one patient was T cell NHL. All patients were treated with surgical excision and most patients received 5-7 circle of CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) based chemotherapy post-operation only. Conclusions: The majority of them had good prognosis. Except two lost cases, 85%（6/7）of patients had a survival period of more than 5 years.

scholarly journals Two cases with primary thyroid lymphoma developed on the basis of Hashimoto's thyroiditis

2015 ◽  
Author(s):  
Hande Peynirci ◽  
Pinar Sisman ◽  
Cigdem Aksu ◽  
Ozen Oz Gul ◽  
Soner Cander ◽  
...  
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Lymphoma ◽  
Primary Thyroid Lymphoma

Clinicopathological Characteristics and A20 (TNFAIP3) Mutation In Primary Thyroid Lymphoma

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4320-4320
Author(s):  
Yasuko Hamada ◽  
Mariko Ishibashi ◽  
Toshio Asayama ◽  
Namiko Okuyama ◽  
Asaka Kondo ◽  
...  
Keyword(s):  
B Cell ◽  
Missense Mutation ◽  
Malt Lymphoma ◽  
Hashimoto’S Thyroiditis ◽  
Genomic Dna ◽  
B Cell Lymphoma ◽  
Negative Regulator ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Lymphoma ◽  
Primary Thyroid Lymphoma

Abstract Background Primary thyroid lymphoma (PTL) is rare, composing approximately 5% of all thyroid malignancies, 1–2.5% of all malignant lymphomas, and fewer than 3% of all extranodal lymphomas. PTL frequently arises in a background of autoimmune thyroid disease, especially Hashimoto’s thyroiditis, but the genetic basis is largely unknown. The NF-κB negative regulator A20, also called tumor necrosis factor-α-induced protein 3 (TNFAIP3), has recently been reported to be frequently inactivated by deletion and/or mutation, which are involved in the pathogenesis of subsets of B-cell lymphomas, especially mucosa-associated lymphoid tissue (MALT) lymphoma. A20 deletion occurs more frequently in ocular adnexa and salivary MALT lymphoma, but there have been very few reports of it in PTL. In this study, we first analyzed the clinicopathologic characteristics of PTL and then investigated whether A20 inactivation by mutation or deletion was frequently detected in PTL. Patients and Methods We retrospectively analyzed 34 PTL patients treated from 2002 to 2013 in our institutions and diagnosed according to the 2008 WHO classification. A20 mutations were examined by directly sequencing genomic DNA using a set of primers. Results The patients included 9 men and 25 women, median age 68 (range, 35–84) years, presenting with a rapidly growing nodular goiter with or without cervical adenopathy (n=30), hoarseness (n=1), or without symptoms related to lymphoma or hypothyroidism (n=3). The pathologic diagnosis of PTL included diffuse large B-cell lymphoma (DLBCL) (n=20), DLBCL with MALT (n=1), and MALT lymphoma (n=13). Twenty-one (62%) had a previous history of Hashimoto’s thyroiditis, and 6 were diagnosed with that condition concurrently with lymphoma. The majority of patients (n=23, 67%) had stage IE disease, although 8 (27%) had stage IIE disease and 3 advanced stage. Compared with MALT lymphoma, the patients with DLBCL presented with larger tumor size including bulky mass (>10 cm), elevated lactate dehydrogenase level, and poor prognosis (relapse rate, 25%) despite receiving THP-COP or CHOP combination therapy with rituximab. MALT lymphoma patients with total thyroidectomy had a good prognosis without chemotherapy; the disease-free survival rate was 100% in the median 40.5-month follow-up. We did not find any routine clinical or biological factors that predicted the evolution from Hashimoto’s thyroiditis to MALT lymphoma. Next, we analyzed A20 mutations in genomic DNA extracted from 16 samples. A20 mutations were identified in 2 of 13 PTL patients examined (15%): 1 of 6 (17%) with DLBCL and 1 of 7 (14%) with MALT lymphoma. Both patients with A20 mutations had Hashimoto’s thyroiditis. Interestingly, the 2 had a common missense mutation in exon 3 (rs2230926 380T>G; F127C), which reduces the ability of A20 to inhibit NF-kB signaling. In one patient, this missense mutation was newly acquired after chemotherapy and radiation. Conclusion We confirmed the histologic heterogeneity of PTL corresponding to different clinical presentations and different prognoses. A20 abnormalities may be related to PTL pathogenesis in some patients. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Primary Thyroid Lymphoma: Maintaining Diagnostic Scrutiny

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A897-A898
Author(s):  
Diana Juhee Chang ◽  
Tina Mosaferi ◽  
Sarah Sangnim Rhee Kim
Keyword(s):  
Flow Cytometry ◽  
B Cell ◽  
Thyroid Nodule ◽  
Hashimoto’S Thyroiditis ◽  
Neck Mass ◽  
Whole Body ◽  
Proliferation Index ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Lymphoma ◽  
Primary Thyroid Lymphoma

Abstract Background: Primary thyroid lymphoma (PTL) is a rare condition representing <5% of thyroid malignancies with diffuse large B-cell lymphoma (DLBCL) as the most common subtype (1). Although not commonly managed in the endocrine sphere, identification is paramount to prognosis and treatment. We present a case of PTL to highlight the importance of diagnostic scrutiny and clinical follow up. Clinical Case: A 69-year-old man with a history of Hashimoto’s thyroiditis presented with an enlarging neck mass. The patient noted development of a left-sided anterior neck mass 3 days prior to seeking care. He denied compressive symptoms and B symptoms (weight loss, fevers, and night sweats). Physical exam revealed a large, firm left-sided thyroid nodule. Serum studies were notable for TSH 39.1 mcIU/mL (0.30-4.7 mcIU/mL), FT4 0.9 ng/dL (0.80-1.70 ng/dL), and TPO Ab 127 IU/mL (<=20 IU/mL). Levothyroxine 100 mcg daily was started. Neck ultrasonography showed a 54 mm hypoechoic, solid left thyroid nodule without calcifications. No abnormal cervical lymph nodes were present. FNA revealed a mixed population of small lymphocytes with no monoclonal B cell population or T cell aberrancies on flow cytometry. In the setting of ongoing nodular growth, the patient underwent core needle biopsy which revealed DLBCL (Ki67 proliferation index >80%, EBV-EBER negative). For diagnostic confirmation and staging, a whole-body FDG-PET scan was performed with an intensely FDG-avid left thyroid mass and no metabolic evidence of additional lymphoproliferative disease. Bone marrow biopsy did not show lymphomatous involvement. The patient was diagnosed with primary thyroid lymphoma and started on chemotherapy with R-CHOP. Conclusion: PTL commonly presents as a rapidly enlarging, painless neck mass that may be accompanied by B symptoms. Hashimoto’s thyroiditis is a known risk factor. Our case in particular required more diligence in the setting of an FNA with mixed lymphoid cells and negative flow cytometry. Initial differential diagnosis included intrathyroidal lymph node, Hashimoto’s thyroiditis, thyroid adenoma/malignancy with a false FNA, and lymphoma. Notably, FNA biopsy is only associated with 71% sensitivity in diagnosing PTL, whereas core biopsy has a 93% sensitivity rate (2). Upon histopathologic disease diagnosis, collaboration with oncology is needed for further staging and initiation of chemotherapy +/- radiation. References: (1) Pavlidis ET, Pavlidis TE. A Review of Primary Thyroid Lymphoma: Molecular Factors, Diagnosis and Management. J Invest Surg. 2019;32(2):137-142. (2) Diaconescu MR, Costea I, Glod M, Diaconescu S. An Unwonted Clinicopathological Subtype of Thyroid Primary Lymphoma. Chirurgia. 2016;111(5):428-431.

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