Case Report
Rare Neoplastic Condition: How to Treat a Thyroid Lymphoma?
Marica GrassoIntroduction: Primary Thyroid Lymphoma (PTL), although a rare malignancy, can arise in common chronic inflammatory conditions such as Hashimoto’s thyroiditis. Early detection of malignancy can play a vital role in improved outcomes. Case Report: We report the case of a 61-year-old man who was referred to the emergency unit due to compressive cervical symptoms. Fine needle aspiration cytology of the thyroid gland was performed, proving the presence of a dedifferentiated neoplasm (Tyr5). The patient was submitted to a total thyroidectomy and histological examination revealed a diagnosis of extra nodal marginal B-cell lymphoma (MALT lymphoma) in a background of chronic lymphocytic thyroiditis. Results: Thyroid gland does not contain lymphoid tissue. Under pathological conditions, the appearance of lymphocytes may occur promoting the further development of the disease. This close relationship is probably due to chronic antigenic stimulation leading to malignant transformation. In this clinical case, the previous diagnosis of Hashimoto’s thyroiditis was not known, but the thyroid histological examination proved the coexistence of this autoimmune disease. Conclusion: PTL is a rare disease and the pre-operative diagnosis is not easy. To achieve a permanent resolution of symptoms or a survival improvement, active surgical intervention is mandatory.