Therapeutic Effect of Primary Thyroid Lymphoma: Analysis of 20 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 XIEJing , DENGXian-zhao ,  FANYou-ben , KANGJie , DINGZheng , WUBo , YANGZhi-li , ZHENGQi

Department of General Surgery, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, and Center of Thyroid and Parathyroid, Shanghai Jiao Tong University, Shanghai 200233, China;

Corresponding author：

FANYou-ben, Email: fanyouben2006@163.com

Keywords：

Thyroid lymphoma; Operation; Chemoradiotherapy; Prognosis

DOI：

10.7507/1007-9424.20140264

Video：

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Objective To summarize the clinical and pathological manifestation, therapy, and prognosis of primary thyroid lymphoma(PTL). Methods The clinical and pathological data of 20 patients with PTL treated in our hospital from Jan.2002 to Feb.2014 were retrospectively analyzed. Results Of the 20 patients, 14 patients were female, 6 patients were male. The median age were 63.5 years old (45-77 years old). Seven patients (35.0%) were diffused large B-cell lymphoma (DLBCL), and 12 patients (60.0%) were extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma, 1 patient (5.0%) was follicular lymphoma (FL). Twelve patients complicated with Hashimoto thyroiditis. Six patients(30.0%) accepted surgery only, 13 patients(65.0%) were supplemented with chemotherapy and (or) radiotherapy, 1 patient (5.0%) accepted chemotherapy and radiotherapy only. Two patients lost during follow-up, but 18 patients were followed-up for 6-104 months with the median time of 46.5 months. During the follow-up period, 6 patients died of PTL. The cumulative survival rates of 2-year and 5-year were 74.4% and 66.9%, respectively. Conclusion Most PTL are B-cell original non-Hodgkin lymphoma. In order to get good prognosis, chemotherapy and (or) radiotherapy are mostly needed, while surgery is performed for definitive pathological diagnosis.

Citation： XIEJing, DENGXian-zhao, FANYou-ben, KANGJie, DINGZheng, WUBo, YANGZhi-li, ZHENGQi. Therapeutic Effect of Primary Thyroid Lymphoma: Analysis of 20 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(9): 1097-1102. doi: 10.7507/1007-9424.20140264 Copy

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1. Ansell SM, Grant CS, Habermann TM. Primary thyroid lymphoma[J]. Semin Oncol, 1999, 26(3):316-323.
2. Green LD, Mack L, Pasieka JL. Anaplastic thyroid cancer and primary thyroid lymphoma:a review of these rare thyroid malignancies[J]. J Surg Oncol, 2006, 94(8):725-736.
3. Fujita A, Tomita N, Fujita H, et al. Features of primary extranodal lymphoma in Kanagawa, a human T-cell leukemia virus type 1 nonendemic area in Japan[J]. Med Oncol, 2009, 26(1):49-54.
4. 孙燕, 周际昌. 临床肿瘤内科手册[M]. 第4版. 北京:人民卫生出版社, 2003:223-263.
5. Graff-Baker A, Roman SA, Thomas DC, et al. Prognosis of primary thyroid lymphoma:demographic, clinical, and pathologic predictors of survival in 1408 cases[J]. Surgery, 2009, 146(6):1105-1115.
6. Katna R, Shet T, Sengar M, et al. Clinicopathologic study and outcome analysis of thyroid lymphomas:experience from a tertiary cancer center[J]. Head Neck, 2013, 35(2):165-171.
7. Hwang YC, Kim TY, Kim WB, et al. Clinical characteristics of primary thyroid lymphoma in Koreans[J]. Endocr J, 2009, 56(3):399-405.
8. Moshynska OV, Saxena A. Clonal relationship between Hashimoto thyroiditis and thyroid lymphoma[J]. J Clin Pathol, 2008, 61(4):438-444.
9. Yahaya N, Din SW, Ghazali MZ, et al. Primary thyroid lymphoma with elevated free thyroxine level[J]. Singapore Med J, 2011, 52(9):e173-e176.
10. Sakorafas GH, Kokkoris P, Farley DR. Primary thyroid lymphoma (correction of lympoma):diagnostic and therapeutic dilemmas[J]. Surg Oncol, 2010, 19(4):e124-e129..
11. Ma B, Jia Y, Wang Q, et al.Ultrasound of primary thyroid non-Hodgkin's lymphoma[J]. Clin Imaging, 2014, 38(5):621-626.
12. Kim HC, Han MH, Kim KH, et al. Primary thyroid lymphoma:CT findings[J]. Eur J Radiol, 2003, 46(3):233-239.
13. Treglia G, Del Ciello A, Di Franco D. Recurrent lymphoma in the thyroid gland detected by fluorine-18-fluorodeoxyglucose PET/CT[J]. Endocrine, 2013, 43(1):242-243.
14. Chander S, Zingas AP, Bloom DA, et al. Positron emission tomography in primary thyroid lymphoma[J]. Clin Nucl Med, 2004, 29(9):572-573.
15. Jaffe ES, Banks PM, Nathwani B, et al. Recommendations for the reporting of lymphoid neoplasms:a report from the Association of Directors of Anatomic and Surgical Pathology[J]. Mod Pathol, 2004, 17(1):131-135.
16. Walsh S, Lowery AJ, Evoy D, et al. Thyroid lymphoma:recent advances in diagnosis and optimal management strategies[J]. Oncologist, 2013, 18(9):994-1003.
17. Demharter J, Müller P, Wagner T, et al. Percutaneous coreneedle biopsy of enlarged lymph nodes in the diagnosis and subclassification of malignant lymphomas[J]. Eur Radiol, 2001, 11(2):276-283.
18. Sangalli G, Serio G, Zampatti C, et al. Fine needle aspiration cytology of primary lymphoma of the thyroid:a report of 17 cases[J]. Cytopathology, 2001, 12(4):257-263.
19. Pyke CM, Grant CS, Habermann TM, et al. Non-Hodgkin's lymphoma of the thyroid:is more than biopsy necessary?[J]. World J Surg, 1992, 16(4):604-609.
20. Derringer GA, Thompson LD, Frommelt RA, et al. Malignant lymphoma of the thyroid gland:a clinicopathologic study of 108 cases[J]. Am J Surg Pathol, 2000, 24(5):623-639.
21. Kikuchi M, Shinohara S, Fujiwara K, et al. Clinical evaluation of 24 cases of primary thyroid malignant lymphoma[J]. Nihon Jibiinkoka Gakkai Kaiho, 2011, 114(11):855-863.
22. Sun XS, Bay JO, Marcy P, et al. Treatment of primary thyroid lymphomas[J]. Bull Cancer, 2013, 100(10):1031-1042.
23. Horning SJ, Weller E, Kim K, et al. Chemotherapy with or without radiotherapy in limited-stage diffuse aggressive non-Hodgkin's lymphoma:Eastern Cooperative Oncology Group study 1484[J]. J Clin Oncol, 2004, 22(15):3032-3038.
24. Alzouebi M, Goepel JR, Horsman JM, et al. Primary thyroid lymphoma:the 40 year experience of a UK lymphoma treatment centre[J]. Int J Oncol, 2012, 40(6):2075-2080.
25. Doria R, Jekel JF, Cooper DL. Thyroid lymphoma. The case for combined modality therapy[J]. Cancer, 1994, 73(1):200-206.

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