Progress in diagnosis and treatment of primary thyroid lymphoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

PENG Yang , KONG Xiangzi , JIN Junyi , CHEN Hang , WANG Baosheng ,  SUN Shaolong

Department of Pancreatic Endocrine Surgery, Shengjing Hospital Affiliated to China Medical University, Shenyang 110004, P. R. China;

Corresponding author：

SUN Shaolong, Email: sunsl@sj-hospital.org

Keywords：

primary thyroid lymphoma; Hashimoto thyroiditis; diagnosis and treatment; review

DOI：

10.7507/1007-9424.201808097

Video：

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Objective To investigate the diagnosis and treatment of primary thyroid lymphoma.Method Through reading of relevant literatures at home and abroad in recent years, the diagnosis and treatment progress of primary thyroid lymphoma were summarized.Results The pathogenesis of primary thyroid lymphoma was associated with chronic inflammatory stimuli such as Hashimoto’s thyroiditis. Its preoperative diagnosis mainly relied on ultrasound-guided biopsy. The treatment depended mainly on its pathological type and tumor stage. Surgical resection was mainly used for pathological biopsy and relieving compression symptoms, and radiotherapy and chemotherapy were the main treatments.Conclusions Primary thyroid lymphoma is a rare thyroid malignancy. Being familiar with and understands its clinicopathological features have important guiding significance for preoperative diagnosis, clearing pathological type and staging, and selection of reasonable treatment measures.

Citation： PENG Yang, KONG Xiangzi, JIN Junyi, CHEN Hang, WANG Baosheng, SUN Shaolong. Progress in diagnosis and treatment of primary thyroid lymphoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(3): 380-384. doi: 10.7507/1007-9424.201808097 Copy

1.	Walsh S, Lowery AJ, Evoy D, et al. Thyroid lymphoma: recent advances in diagnosis and optimal management strategies. Oncologist, 2013, 18(9): 994-1003.
2.	Stein SA, Wartofsky L. Primary thyroid lymphoma: a clinical review. J Clin Endocrinol Metab, 2013, 98(8): 3131-3138.
3.	Chai YJ, Hong JH, Koo do H, et al. Clinicopathological characteristics and treatment outcomes of 38 cases of primary thyroid lymphoma: a multicenter study. Ann Surg Treat Res, 2015, 89(6): 295-299.
4.	Watanabe N, Noh JY, Narimatsu H, et al. Clinicopathological features of 171 cases of primary thyroid lymphoma: a long-term study involving 24 553 patients with Hashimoto’s disease. Br J Haematol, 2011, 153(2): 236-243.
5.	Sarinah B, Hisham AN. Primary lymphoma of the thyroid: diagnostic and therapeutic considerations. Asian J Surg, 2010, 33(1): 20-24.
6.	Czopnik P, Aporowicz M, Niepokój-Czopnik A, et al. Primary thyroid lymphoma: a rare but challenging diagnosis. Pol Arch Intern Med, 2017, 127(5): 361-364.
7.	Sharma A, Jasim S, Reading CC, et al. Clinical presentation and diagnostic challenges of thyroid lymphoma: a cohort study. Thyroid, 2016, 26(8): 1061-1067.
8.	Moghaddasi M, Nabovvati M, Razmeh S. Bilateral cavernous sinus thrombosis as first manifestation of primary burkitt lymphoma of the thyroid gland. Neurol Int, 2017, 9(2): 7133.
9.	Green LD, Mack L, Pasieka JL. Anaplastic thyroid cancer and primary thyroid lymphoma: a review of these rare thyroid malignancies. J Surg Oncol, 2006, 94(8): 725-736.
10.	Jaffe ES. The 2008 WHO classification of lymphomas: implications for clinical practice and translational research. Hematology Am Soc Hematol Educ Program, 2009: 523-531.
11.	Alzouebi M, Goepel JR, Horsman JM, et al. Primary thyroid lymphoma: the 40 year experience of a UK lymphoma treatment centre. Int J Oncol, 2012, 40(6): 2075-2080.
12.	Onal C, Li YX, Miller RC, et al. Treatment results and prognostic factors in primary thyroid lymphoma patients: a rare cancer network study. Ann Oncol, 2011, 22(1): 156-164.
13.	Yahaya N, Din SW, Ghazali MZ, et al. Primary thyroid lymphoma with elevated free thyroxine level. Singapore Med J, 2011, 52(9): e173-e176.
14.	Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid, 2016, 26(1): 1-133.
15.	张秀梅, 农琳, 冉旭, 等. 甲状腺淋巴瘤临床病理及超声特征分析. 中华医学杂志, 2017, 97(37): 2936-2939.
16.	Hirokawa M, Kudo T, Ota H, et al. Errata: preoperative diagnostic algorithm of primary thyroid lymphoma using ultrasound, aspiration cytology, and flow cytometry [Endocrine Journal Vol. 64 (9): 859-865, 2017]. Endocr J, 2017, 64(10): 1041-1042.
17.	Wang JH, Chen L, Ren K. Identification of primary thyroid lymphoma with medical imaging: a case report and review of the literature. Oncol Lett, 2014, 8(6): 2505-2508.
18.	Nakadate M, Yoshida K, Ishii A, et al. Is ¹⁸F-FDG PET/CT useful for distinguishing between primary thyroid lymphoma and chronic thyroiditis? Clin Nucl Med, 2013, 38(9): 709-714.
19.	Spielman DB, Badhey A, Kadakia S, et al. Rare thyroid malig- nancies: an overview for the oncologist. Clin Oncol (R Coll Radiol), 2017, 29(5): 298-306.
20.	Sakorafas GH, Kokkoris P, Farley DR. Primary thyroid lymphoma (correction of lympoma): diagnostic and therapeutic dilemmas. Surg Oncol, 2010, 19(4): e124-e129.
21.	Adamczewski Z, Stasiołek M, Dedecjus M, et al. Flow cytometry in the differential diagnostics of Hashimoto’s thyroiditis and MALT lymphoma of the thyroid. Endokrynol Pol, 2015, 66(1): 73-78.
22.	Graff-Baker A, Roman SA, Thomas DC, et al. Prognosis of primary thyroid lymphoma: demographic, clinical, and pathologic predictors of survival in 1,408 cases. Surgery, 2009, 146(6): 1105-1115.
23.	Fujii H, Nakadate M, Tanaka H, et al. Residual FDG uptake of primary thyroid lymphoma after treatment may overestimate residual lymphoma. Ann Nucl Med, 2016, 30(10): 756-759.
24.	Sakorafas GH. What’s the role of surgery in the management of primary thyroid lymphoma? Acta Oncol, 2011, 50(2): 319-320.
25.	Chen C, Tibbetts KM, Tassler AB, et al. Tracheal invasion and perforation from advanced primary thyroid lymphoma: a case report and literature review. Am J Otolaryngol, 2013, 34(5): 559-562.
26.	Harrington KJ, Michalaki VJ, Vini L, et al. Management of non-Hodgkin’s lymphoma of the thyroid: the Royal Marsden Hospital experience. Br J Radiol, 2005, 78(929): 405-410.
27.	梁鹏, 王森, 陈康兵, 等. 原发性甲状腺恶性淋巴瘤的诊治及进展. 中华耳鼻咽喉头颈外科杂志, 2016, 51(4): 313-316.
28.	Dai CW, Zhang GS, Pei MF, et al. Thyroid diffuse large B cell lymphoma (DLBCL) following thyroid medullary cancer: long-term complete remission with R-CHOP therapy. Ann Hematol, 2009, 88(7): 701-702.
29.	Jonak C, Troch M, Müllauer L, et al. Rituximab plus dose-reduced cyclophosphamide, mitoxantrone, vincristine, and prednisolone are effective in elderly patients with diffuse large B-cell lymphoma of the thyroid. Thyroid, 2010, 20(4): 425-427.
30.	Karlin L, Coiffier B. Improving survival and preventing recurrence of diffuse large B-cell lymphoma in younger patients: current strategies and future directions. Onco Targets Ther, 2013, 6: 289-296.
31.	Visco C, Tzankov A, Xu-Monette ZY, et al. Patients with diffuse large B-cell lymphoma of germinal center origin with BCL2 translocations have poor outcome, irrespective of MYC status: a report from an International DLBCL rituximab-CHOP Consortium Program Study. Haematologica, 2013, 98(2): 255-263.
32.	Aggarwal N, Swerdlow SH, Kelly LM, et al. Thyroid carcinoma-associated genetic mutations also occur in thyroid lymphomas. Mod Pathol, 2012, 25(9): 1203-1211.
33.	Ishibashi N, Maebayashi T, Aizawa T, et al. Radiation therapy for cutaneous blastic plasmacytoid dendritic cell neoplasm: a case report and review of the literature. Int J Clin Exp Med, 2015, 8(5): 8204-8209.
34.	Ishibashi N, Maebayashi T, Aizawa T, et al. Hypothyroidism after radiotherapy for primary thyroid lymphoma. Anticancer Res, 2014, 34(8): 4427-4431.

1. Walsh S, Lowery AJ, Evoy D, et al. Thyroid lymphoma: recent advances in diagnosis and optimal management strategies. Oncologist, 2013, 18(9): 994-1003.
2. Stein SA, Wartofsky L. Primary thyroid lymphoma: a clinical review. J Clin Endocrinol Metab, 2013, 98(8): 3131-3138.
3. Chai YJ, Hong JH, Koo do H, et al. Clinicopathological characteristics and treatment outcomes of 38 cases of primary thyroid lymphoma: a multicenter study. Ann Surg Treat Res, 2015, 89(6): 295-299.
4. Watanabe N, Noh JY, Narimatsu H, et al. Clinicopathological features of 171 cases of primary thyroid lymphoma: a long-term study involving 24 553 patients with Hashimoto’s disease. Br J Haematol, 2011, 153(2): 236-243.
5. Sarinah B, Hisham AN. Primary lymphoma of the thyroid: diagnostic and therapeutic considerations. Asian J Surg, 2010, 33(1): 20-24.
6. Czopnik P, Aporowicz M, Niepokój-Czopnik A, et al. Primary thyroid lymphoma: a rare but challenging diagnosis. Pol Arch Intern Med, 2017, 127(5): 361-364.
7. Sharma A, Jasim S, Reading CC, et al. Clinical presentation and diagnostic challenges of thyroid lymphoma: a cohort study. Thyroid, 2016, 26(8): 1061-1067.
8. Moghaddasi M, Nabovvati M, Razmeh S. Bilateral cavernous sinus thrombosis as first manifestation of primary burkitt lymphoma of the thyroid gland. Neurol Int, 2017, 9(2): 7133.
9. Green LD, Mack L, Pasieka JL. Anaplastic thyroid cancer and primary thyroid lymphoma: a review of these rare thyroid malignancies. J Surg Oncol, 2006, 94(8): 725-736.
10. Jaffe ES. The 2008 WHO classification of lymphomas: implications for clinical practice and translational research. Hematology Am Soc Hematol Educ Program, 2009: 523-531.
11. Alzouebi M, Goepel JR, Horsman JM, et al. Primary thyroid lymphoma: the 40 year experience of a UK lymphoma treatment centre. Int J Oncol, 2012, 40(6): 2075-2080.
12. Onal C, Li YX, Miller RC, et al. Treatment results and prognostic factors in primary thyroid lymphoma patients: a rare cancer network study. Ann Oncol, 2011, 22(1): 156-164.
13. Yahaya N, Din SW, Ghazali MZ, et al. Primary thyroid lymphoma with elevated free thyroxine level. Singapore Med J, 2011, 52(9): e173-e176.
14. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid, 2016, 26(1): 1-133.
15. 张秀梅, 农琳, 冉旭, 等. 甲状腺淋巴瘤临床病理及超声特征分析. 中华医学杂志, 2017, 97(37): 2936-2939.
16. Hirokawa M, Kudo T, Ota H, et al. Errata: preoperative diagnostic algorithm of primary thyroid lymphoma using ultrasound, aspiration cytology, and flow cytometry [Endocrine Journal Vol. 64 (9): 859-865, 2017]. Endocr J, 2017, 64(10): 1041-1042.
17. Wang JH, Chen L, Ren K. Identification of primary thyroid lymphoma with medical imaging: a case report and review of the literature. Oncol Lett, 2014, 8(6): 2505-2508.
18. Nakadate M, Yoshida K, Ishii A, et al. Is ¹⁸F-FDG PET/CT useful for distinguishing between primary thyroid lymphoma and chronic thyroiditis? Clin Nucl Med, 2013, 38(9): 709-714.
19. Spielman DB, Badhey A, Kadakia S, et al. Rare thyroid malig- nancies: an overview for the oncologist. Clin Oncol (R Coll Radiol), 2017, 29(5): 298-306.
20. Sakorafas GH, Kokkoris P, Farley DR. Primary thyroid lymphoma (correction of lympoma): diagnostic and therapeutic dilemmas. Surg Oncol, 2010, 19(4): e124-e129.
21. Adamczewski Z, Stasiołek M, Dedecjus M, et al. Flow cytometry in the differential diagnostics of Hashimoto’s thyroiditis and MALT lymphoma of the thyroid. Endokrynol Pol, 2015, 66(1): 73-78.
22. Graff-Baker A, Roman SA, Thomas DC, et al. Prognosis of primary thyroid lymphoma: demographic, clinical, and pathologic predictors of survival in 1,408 cases. Surgery, 2009, 146(6): 1105-1115.
23. Fujii H, Nakadate M, Tanaka H, et al. Residual FDG uptake of primary thyroid lymphoma after treatment may overestimate residual lymphoma. Ann Nucl Med, 2016, 30(10): 756-759.
24. Sakorafas GH. What’s the role of surgery in the management of primary thyroid lymphoma? Acta Oncol, 2011, 50(2): 319-320.
25. Chen C, Tibbetts KM, Tassler AB, et al. Tracheal invasion and perforation from advanced primary thyroid lymphoma: a case report and literature review. Am J Otolaryngol, 2013, 34(5): 559-562.
26. Harrington KJ, Michalaki VJ, Vini L, et al. Management of non-Hodgkin’s lymphoma of the thyroid: the Royal Marsden Hospital experience. Br J Radiol, 2005, 78(929): 405-410.
27. 梁鹏, 王森, 陈康兵, 等. 原发性甲状腺恶性淋巴瘤的诊治及进展. 中华耳鼻咽喉头颈外科杂志, 2016, 51(4): 313-316.
28. Dai CW, Zhang GS, Pei MF, et al. Thyroid diffuse large B cell lymphoma (DLBCL) following thyroid medullary cancer: long-term complete remission with R-CHOP therapy. Ann Hematol, 2009, 88(7): 701-702.
29. Jonak C, Troch M, Müllauer L, et al. Rituximab plus dose-reduced cyclophosphamide, mitoxantrone, vincristine, and prednisolone are effective in elderly patients with diffuse large B-cell lymphoma of the thyroid. Thyroid, 2010, 20(4): 425-427.
30. Karlin L, Coiffier B. Improving survival and preventing recurrence of diffuse large B-cell lymphoma in younger patients: current strategies and future directions. Onco Targets Ther, 2013, 6: 289-296.
31. Visco C, Tzankov A, Xu-Monette ZY, et al. Patients with diffuse large B-cell lymphoma of germinal center origin with BCL2 translocations have poor outcome, irrespective of MYC status: a report from an International DLBCL rituximab-CHOP Consortium Program Study. Haematologica, 2013, 98(2): 255-263.
32. Aggarwal N, Swerdlow SH, Kelly LM, et al. Thyroid carcinoma-associated genetic mutations also occur in thyroid lymphomas. Mod Pathol, 2012, 25(9): 1203-1211.
33. Ishibashi N, Maebayashi T, Aizawa T, et al. Radiation therapy for cutaneous blastic plasmacytoid dendritic cell neoplasm: a case report and review of the literature. Int J Clin Exp Med, 2015, 8(5): 8204-8209.
34. Ishibashi N, Maebayashi T, Aizawa T, et al. Hypothyroidism after radiotherapy for primary thyroid lymphoma. Anticancer Res, 2014, 34(8): 4427-4431.

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