Thyroid lymphoma

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Thyroid lymphoma
SpecialtyENT surgery, endocrinology, oncology

Thyroid lymphoma is a rare cancer constituting 1% to 2% of all thyroid cancers and less than 2% of lymphomas. Thyroid lymphomas are classified as non–Hodgkin's B-cell lymphomas in a majority of cases, although Hodgkin's lymphoma of the thyroid has also been identified.[1]

Signs and symptoms[edit]

As with other thyroid lesions, thyroid lymphoma affects predominantly females over 70 years of age with a history of Hashimoto's thyroiditis. Thus, Hashimoto's thyroiditis is considered a risk factor for thyroid lymphoma development. Thyroid lymphoma manifests as a rapidly enlarging neck mass which may compress the nearby trachea thereby causing narrowing or obstruction of the airway resulting in breathing difficulties or even respiratory failure. On physical examination, affected people typically exhibit a firm thyroid gland and enlarged lymph nodes.[citation needed]

Diagnosis[edit]

Thyroid lymphoma poses a diagnostic and therapeutic challenge. This is because several manifestation patterns are similar to those of anaplastic thyroid cancer (ATC). Fine-needle aspiration (FNA) helps distinguish the two entities preoperatively.[citation needed]

Histopathology[edit]

The majority of thyroid lymphomas are non–Hodgkin's B-cell lymphomas; a minority exhibit properties of T-cell lymphomas .[citation needed]

Staging[edit]

Staging of thyroid lymphoma is shown in the table below[citation needed]

Stage Characteristics
Lymphoma is located within the thyroid
Lymphoma is located within the thyroid and regional lymph-nodes
Lymphoma is located at both sides of diaphragm
Dissemination of lymphoma

Treatment[edit]

Combined modality therapy is the most common approach for the initial treatment of thyroid lymphomas. The CHOP regimen (cyclophosphamide, doxorubicin, vincristine and prednisone) has been shown to be highly effective for many types of thyroid lymphoma.[medical citation needed] However, it is suggested to perform radiation therapy only for MALT resulting a 96% complete response, with only a 30% relapse rate. Surgical treatment might be performed for patients with thyroid lymphoma in addition to chemotherapy and radiation, particularly for MALT lymphomas.[citation needed]

Prognosis[edit]

The factors of poor prognosis for people with thyroid lymphoma are advanced stage of the tumor, large size (>10 cm) as well as spreading to mediastinum. The overall survival for primary thyroid lymphoma is 50% to 70%, ranging from 80% in stage IE to less than 36% in stage IIE and IVE in 5 years.[citation needed]

References[edit]

  1. ^ Sakorafas GH, Kokkoris P, Farley DR (2010). "Primary thyroid lymphoma (correction of lympoma): diagnostic and therapeutic dilemmas". Surg. Oncol. 19 (4): 124–29. doi:10.1016/j.suronc.2010.06.002. PMID 20620043.

External links[edit]

Classification