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Review
. 2013 Jul 15:8:116.
doi: 10.1186/1746-1596-8-116.

Thyroid nodule as a first manifestation of Hodgkin lymphoma-report of two cases and literature review

Ewelina Szczepanek-Parulska  1 , Malgorzata Szkudlarek, Przemyslaw Majewski, Jan Breborowicz, Marek Ruchala
Affiliations
Review

Thyroid nodule as a first manifestation of Hodgkin lymphoma-report of two cases and literature review

Ewelina Szczepanek-Parulska et al. Diagn Pathol. .

Abstract

Lymphomas account for less than 5% of thyroid malignant lesions. Vast majority of them are B-cell non-Hodgkin lymphomas (NHL), while Hodgkin lymphoma (HL) is extremely rare. Here we present two cases of HL, at baseline manifesting as a thyroid lesion. First patient, 29-year-old pregnant female, initially suspected for metastatic medullary thyroid cancer, was eventually diagnosed with mixed cellularity type of thyroid HL. Second patient, 22-year-old woman with suspicion of advanced thyroid cancer, was in the end diagnosed with an extra-lymphatic classical HL of the thyroid. In both cases, despite repeated fine-needle aspiration biopsy, cytological examination gave inconclusive or misleading results. On histopathological examination, thyroid tumor cells were positive for CD15 and CD30 antigen, which is typical for Reed-Sternberg cells. In the report authors also discuss difficulties in management as well as potential importance of novel methods such as FISH, PCR and other molecular techniques in diagnostics of thyroid lymphomas.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2896947559559648.

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Figures

Figure 1
Figure 1
Histopathological examination of the material obtained during thyroidectomy - Hodgkin lymphoma - mixed cellularity (MC) type in Patient 1 (H&E, magnification × 10).
Figure 2
Figure 2
Retrospective verification of cytological specimen obtained preoperatively during fine-needle aspiration biopsy of the thyroid in the Patient 1. An arrow indicates Reed-Sternberg cell, presence of which might provide preoperative diagnosis of Hodgkin lymphoma (H&E, magnification × 400).
Figure 3
Figure 3
Histopathological examination of the material obtained during thyroidectomy - Hodgkin lymphoma - nodular sclerosis (NS) type in Patient 2 (H&E, magnification × 10).
Figure 4
Figure 4
Reed-Sternberg cells positive for CD 30 in Patient 2 (H&E, magnification × 10).
See this image and copyright information in PMC

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