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Case Reports
. 2023 Apr 18;15(4):e37750.
doi: 10.7759/cureus.37750. eCollection 2023 Apr.

Thyromegaly: Not The Usual Cause

N S Thillai Arunachalam  1 , Saranya N  1 , Nagarajan Priyathersini  1 , Arthi M  1 , Suhaildeen Kajamohideen  2
Affiliations
Case Reports

Thyromegaly: Not The Usual Cause

N S Thillai Arunachalam et al. Cureus. .

Abstract

Non-Hodgkin lymphoma (NHL) of the thyroid is a very rare condition. Swelling of the neck is the usual presentation among patients. Of all thyroid malignancies, only a very small portion accounts for NHL of the thyroid. Here, we present two cases of diffuse large B-cell NHL of the thyroid. Preoperative diagnosis helps in the management of patients with chemotherapy, but in rare cases, surgical removal of the thyroid is done to reduce obstructive symptoms. The diagnosis is usually made based on fine-needle aspiration cytology and biopsy with immunohistochemistry. In these two cases, the patients presented with a history of a rapidly growing mass in the neck for three to four months, but the treatment modalities differed. In one of the cases, the patient received six cycles of chemotherapy, and in the other case, the patient underwent a total thyroidectomy, followed by six cycles of chemotherapy, though chemotherapy is the standard treatment option over surgical removal of the thyroid.

Keywords: diffuse large b-cell lymphoma; immunohistochemistry; non-hodgkin lymphoma of thyroid; thyroid malignancies; thyroid swelling.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Case one.
A: CT image showing lesions in the thyroid gland bilaterally. B: Fragments of the thyroid tissue with diffuse infiltrates of atypical lymphoid cells (H&E, 50×). C: Fragments of the thyroid tissue with diffuse infiltrates of atypical lymphoid cells (H&E, 100×). D: Diffuse infiltrates of atypical lymphoid cells with numerous mitosis and apoptosis (H&E, 400×). E: Diffuse membranous positivity of CD45 (IHC, 400×). F: Diffuse nuclear positivity of MUM1 (IHC, 400×). G: Diffuse nuclear and cytoplasmic positivity of BCL2 (IHC, 400×). H: Diffuse nuclear positivity of BCL6 (IHC, 400×). I: Diffuse nuclear positivity of Ki67 of 90% (IHC, 400×). J: Diffuse membranous positivity of CD20 (IHC, 400×). K: Scattered CD5 strong membranous positivity in the surrounding reactive T cells (IHC, 400×). H&E: hematoxylin & eosin; IHC: immunohistochemistry
Figure 2
Figure 2. Case two.
A: Total thyroidectomy specimen showing diffuse tan-brown solid lesion. B: Fragments of the thyroid tissue with diffuse infiltrates of atypical lymphoid cells (H&E, 50×). C: Fragments of the thyroid tissue with diffuse infiltrates of atypical lymphoid cells (H&E, 100×). D: Diffuse infiltrates of atypical lymphoid cells with scattered mitosis and apoptosis (H&E, 400×). E: Diffuse membranous positivity of CD5 (IHC, 400×). F: Diffuse membranous positivity of CD45 (IHC, 400×). G: Diffuse membranous positivity of CD20 (IHC, 400×). H: Diffuse nuclear and cytoplasmic positivity of BCL2 (IHC, 400×). I: Diffuse nuclear positivity of MUM1 (IHC, 400×). J: Diffuse nuclear positivity of BCL6 (IHC, 400×). K: Diffuse nuclear positivity of Ki67 of 70% (IHC, 400×). L: CD3 negative in tumor cells (IHC, 400×). M: Scattered nuclear positivity of C-MYC of 20% (hence negative) (IHC, 400×). H&E: hematoxylin & eosin; IHC: immunohistochemistry
See this image and copyright information in PMC

References

    1. Non-Hodgkin's lymphoma: a review. Singh R, Shaik S, Negi BS, Rajguru JP, Patil PB, Parihar AS, Sharma U. J Family Med Prim Care. 2020;9:1834–1840. - PMC - PubMed
    1. Occurrence and prognosis of extranodal lymphomas. Freeman C, Berg JW, Cutler SJ. Cancer. 1972;29:252–260. - PubMed
    1. Primary non-Hodgkin's lymphoma of the thyroid gland: a population based study. Pedersen RK, Pedersen NT. Histopathology. 1996;28:25–32. - PubMed
    1. Cancer risks in patients with chronic lymphocytic thyroiditis. Holm LE, Blomgren H, Löwhagen T. N Engl J Med. 1985;312:601–604. - PubMed
    1. Malignant lymphoma of the thyroid gland: a clinicopathologic study of 108 cases. Derringer GA, Thompson LD, Frommelt RA, Bijwaard KE, Heffess CS, Abbondanzo SL. Am J Surg Pathol. 2000;24:623–639. - PubMed

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