Primary Thyroid Lymphoma Associated with Multinodular Goiter
Keywords:
primary thyroid lymphoma; B-cell lymphoma; non-Hodgkin lymphoma; Hashimoto's thyroiditis.Abstract
Introduction: Primary thyroid lymphoma is rare, representing 2.5% of non-Hodgkin lymphomas and less than 5% of malignant thyroid tumors.
Objective: To describe the clinical findings, complementary studies, therapeutic management, and evolution of a case of primary thyroid lymphoma associated with multinodular goiter.
Case report: A 67-year-old female patient presented with a sudden increase in volume at the base of her neck, accompanied by afternoon fever. Despite not exhibiting compressive symptoms or alterations in thyroid function, she had experienced a 3 kg weight loss in the last three months. Her medical history revealed a history of multinodular goiter and subclinical hypothyroidism. During the physical examination, a grade 3 goiter with irregular nodules and cervical lymphadenopathy was observed. Imaging studies showed features suggestive of malignancy, prompting a fine-needle aspiration biopsy. Cytological findings indicated a lymphoid infiltrate, suggesting non-Hodgkin lymphoma. After a multidisciplinary evaluation, chemotherapy was initiated. The patient responded favorably, with a marked reduction in glandular volume and resolution of the nodules.
Conclusions: This case highlights the importance of considering primary thyroid lymphoma in the diagnosis of thyroid nodules, especially in patients with thyroiditis; an appropriate approach can lead to a positive prognosis.
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