Early cytological diagnosis of extranodal stage I, primary thyroid Non-Hodgkin lymphoma in elderly patients. Report of two cases and review of the literature

BMC Surg. 2013;13 Suppl 2(Suppl 2):S49. doi: 10.1186/1471-2482-13-S2-S49. Epub 2013 Oct 8.

Abstract

Background: Primary thyroid lymphomas (PTLs) account for 5% of thyroid malignant tumors and often develop in patients with Hashimoto Thyroiditis (HT). Fine-needle cytology (FNC) is widely used in the diagnosis of thyroid nodules, including those arising in HT. Two PTL cases in HT elderly patients are here described and discussed.

Methods: FNC was performed in rapidly enlarged thyroid nodules of 2 elderly patients under ultrasound (US) control. FNC was used to prepare conventional cytologic smears, immunocytochemistry (ICC) and flow cytometry (FC) assessment of cell populations.

Results: The above cases were diagnosed as well differentiated, small B-cell and diffuse large B-cell thyroid lymphomas, respectively, by means of FNC. The histological diagnoses were mucosa-associated non Hodgkin lymphoma (MALT) and diffuse large B-cell lymphoma (DLBCL), confirming FNC diagnoses, and patients were treated accordingly.

Conclusions: FNC diagnosis of PTL is reliable and accurate; it may be conveniently used in the clinical practice since it provides indications for appropriate therapeutic procedures or diagnostic surgery, and avoids to treat benign nodules.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Early Detection of Cancer*
  • Female
  • Humans
  • Lymphatic Metastasis
  • Lymphoma, Non-Hodgkin / pathology*
  • Male
  • Neoplasm Staging
  • Thyroid Neoplasms / pathology*