Primary thyroid lymphoma: clinical features, treatment and outcome: a report of 8 cases

Abstract

Aim: To assess the clinical findings and response to treatment of patients with primary thyroid lymphoma.

Methods: Patients with primary thyroid lymphoma were identified by reviewing the diagnoses of all patients with thyroid malignancies diagnosed at Christchurch Hospital between 1980-91. The records of patients with primary thyroid lymphoma were abstracted.

Results: During the 12 year period eight patients (6 females, 2 males) with primary thyroid lymphoma were diagnosed and treated. The median age was 78 years (range 18-90 yr). All patients presented with recent thyroid masses and obstructive symptoms were prominent. Two patients were initially referred with endocrine dysfunction--one thyrotoxic and one hypothyroid. Six patients had nonHodgkin lymphoma and two Hodgkin's disease, with all having stage IA disease. Two patients were treated by thyroidectomy, and in the remaining six patients the thyroid lymphoma masses regressed following radiotherapy with the two youngest patients also receiving chemotherapy. At follow up all five elderly patients have since died--two of disseminated lymphoma, two of concurrent cancers and one of vascular disease, and the three younger patients remain in remission after 4.5, 6.5 and 10.5 years.

Conclusion: Primary thyroid lymphoma usually presents with obstructive symptoms, but there may be associated thyroid dysfunction. Thyroid lymphoma masses respond well to radiotherapy.