J Korean Surg Soc.  2011 Dec;81(6):374-379. 10.4174/jkss.2011.81.6.374.

Primary thyroid mucosa-associated lymphoid tissue lymphoma; a clinicopathological study of seven cases

Affiliations
  • 1Department of Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • 2Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. surghsc@yuhs.ac

Abstract

PURPOSE
Primary thyroid mucosa-associated lymphoid tissue (MALT) lymphoma is a very rare subgroup of thyroid lymphoma, accounting for about 6 to 28% of all primary thyroid lymphomas. The purpose of this study was to evaluate its clinicopathological features and treatment outcomes.
METHODS
We identified seven patients with thyroid MALT lymphoma who were treated between January 1997 and December 2007, and reviewed their clinicopathological features and follow-up outcomes.
RESULTS
There were five female and two male patients, and their mean age was 73 years. All patients presented with palpable neck mass. Two patients had hoarseness and dyspnea. All patients had a history of Hashimoto's thyroiditis with a mean of 175 months. Malignant lymphoma was suspected in only three patients using core needle biopsy. Four patients underwent thyroidectomy in the absence of preoperative pathologic confirmation, and histologic diagnosis was obtained after surgery. As initial treatment, complete surgical resection was performed in five patients, radiotherapy in one, and a combination of chemotherapy and radiotherapy in one. Six patients were alive for the mean follow-up period of 66 months and one patient died of unrelated causes. There were neither recurrences nor disease-specific mortalities.
CONCLUSION
When primary thyroid MALT lymphoma occurs in the thyroid or is confined to the neck, it responds well to local treatment such as surgical resection and external beam radiation therapy.

Keyword

Primary thyroid MALT lymphoma; Hashimoto's thyroiditis; Diffuse large B-cell lymphoma

MeSH Terms

Accounting
Biopsy, Large-Core Needle
Dyspnea
Female
Follow-Up Studies
Hoarseness
Humans
Lymphoid Tissue
Lymphoma
Lymphoma, B-Cell, Marginal Zone
Male
Neck
Recurrence
Thyroid Gland
Thyroidectomy
Thyroiditis

Figure

  • Fig. 1 (A) Gross appearance of patient, (B) computed tomography scan showing homogenously enlarged thyroid gland. (C) Specimen showing firm, enlarged thyroid gland, and (D) microscopic features of mucosaassociated lymphoid tissue lymphoma (H&E, ×100).


Cited by  1 articles

Synchronous Occurrence of Papillary Thyroid Carcinoma and Mucosa-Associated Lymphoid Tissue Lymphoma: a Single Case Report
Jun Suk Byun, Hye Yoon Lee, Ki Won Chun, Dae Sung Yoon
Int J Thyroidol. 2016;9(2):195-199.    doi: 10.11106/ijt.2016.9.2.195.


Reference

1. Pedersen RK, Pedersen NT. Primary non-Hodgkin's lymphoma of the thyroid gland: a population based study. Histopathology. 1996. 28:25–32.
2. Isaacson P, Wright DH. Extranodal malignant lymphoma arising from mucosa-associated lymphoid tissue. Cancer. 1984. 53:2515–2524.
3. Thieblemont C, Mayer A, Dumontet C, Barbier Y, Callet-Bauchu E, Felman P, et al. Primary thyroid lymphoma is a heterogeneous disease. J Clin Endocrinol Metab. 2002. 87:105–111.
4. Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Cleary ML, et al. A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood. 1994. 84:1361–1392.
5. Jaffe ES, Harris NL, Diebold J, Muller-Hermelink HK. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues. A progress report. Am J Clin Pathol. 1999. 111:1 Suppl 1. S8–S12.
6. Hyjek E, Isaacson PG. Primary B cell lymphoma of the thyroid and its relationship to Hashimoto's thyroiditis. Hum Pathol. 1988. 19:1315–1326.
7. Derringer GA, Thompson LD, Frommelt RA, Bijwaard KE, Heffess CS, Abbondanzo SL. Malignant lymphoma of the thyroid gland: a clinicopathologic study of 108 cases. Am J Surg Pathol. 2000. 24:623–639.
8. Widder S, Pasieka JL. Primary thyroid lymphomas. Curr Treat Options Oncol. 2004. 5:307–313.
9. Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M. Report of the Committee on Hodgkin's Disease Staging Classification. Cancer Res. 1971. 31:1860–1861.
10. Ansell SM, Grant CS, Habermann TM. Primary thyroid lymphoma. Semin Oncol. 1999. 26:316–323.
11. Zinzani PL, Magagnoli M, Galieni P, Martelli M, Poletti V, Zaja F, et al. Nongastrointestinal low-grade mucosa-associated lymphoid tissue lymphoma: analysis of 75 patients. J Clin Oncol. 1999. 17:1254.
12. Kaplan MA, Pettit CL, Zukerberg LR, Harris NL. Primary lymphoma of the trachea with morphologic and immunophenotypic characteristics of low-grade B-cell lymphoma of mucosa-associated lymphoid tissue. Am J Surg Pathol. 1992. 16:71–75.
13. Nicholson AG, Wotherspoon AC, Diss TC, Butcher DN, Sheppard MN, Isaacson PG, et al. Pulmonary B-cell non-Hodgkin's lymphomas. The value of immunohistochemistry and gene analysis in diagnosis. Histopathology. 1995. 26:395–403.
14. Isaacson PG, Chan JK, Tang C, Addis BJ. Low-grade B-cell lymphoma of mucosa-associated lymphoid tissue arising in the thymus. A thymic lymphoma mimicking myoepithelial sialadenitis. Am J Surg Pathol. 1990. 14:342–351.
15. Mattia AR, Ferry JA, Harris NL. Breast lymphoma. A B-cell spectrum including the low grade B-cell lymphoma of mucosa associated lymphoid tissue. Am J Surg Pathol. 1993. 17:574–587.
16. Wotherspoon AC, Hardman-Lea S, Isaacson PG. Mucosaassociated lymphoid tissue (MALT) in the human conjunctiva. J Pathol. 1994. 174:33–37.
17. Parveen T, Navarro-Roman L, Medeiros LJ, Raffeld M, Jaffe ES. Low-grade B-cell lymphoma of mucosa-associated lymphoid tissue arising in the kidney. Arch Pathol Lab Med. 1993. 117:780–783.
18. Kumar S, Kumar D, Kaldjian EP, Bauserman S, Raffeld M, Jaffe ES. Primary low-grade B-cell lymphoma of the dura: a mucosa associated lymphoid tissue-type lymphoma. Am J Surg Pathol. 1997. 21:81–87.
19. Zucca E, Bertoni F, Roggero E, Cavalli F. The gastric marginal zone B-cell lymphoma of MALT type. Blood. 2000. 96:410–419.
20. Isaacson PG. Gastric MALT lymphoma: from concept to cure. Ann Oncol. 1999. 10:637–645.
21. Isaacson PG. Mucosa-associated lymphoid tissue lymphoma. Semin Hematol. 1999. 36:139–147.
22. Sangalli G, Serio G, Zampatti C, Lomuscio G, Colombo L. Fine needle aspiration cytology of primary lymphoma of the thyroid: a report of 17 cases. Cytopathology. 2001. 12:257–263.
23. Screaton NJ, Berman LH, Grant JW. Head and neck lymphadenopathy: evaluation with US-guided cutting-needle biopsy. Radiology. 2002. 224:75–81.
24. Tsang RW, Gospodarowicz MK, Pintilie M, Wells W, Hodgson DC, Sun A, et al. Localized mucosa-associated lymphoid tissue lymphoma treated with radiation therapy has excellent clinical outcome. J Clin Oncol. 2003. 21:4157–4164.
25. Laing RW, Hoskin P, Hudson BV, Hudson GV, Harmer C, Bennett MH, et al. The significance of MALT histology in thyroid lymphoma: a review of patients from the BNLI and Royal Marsden Hospital. Clin Oncol (R Coll Radiol). 1994. 6:300–304.
26. Vigliotti A, Kong JS, Fuller LM, Velasquez WS. Thyroid lymphomas stages IE and IIE: comparative results for radiotherapy only, combination chemotherapy only, and multimodality treatment. Int J Radiat Oncol Biol Phys. 1986. 12:1807–1812.
27. Mikosch P, Würtz FG, Gallowitsch HJ, Kresnik E, Lind P. F-18-FDG-PET in a patient with Hashimoto's thyroiditis and MALT lymphoma recurrence of the thyroid. Wien Med Wochenschr. 2003. 153:89–92.
Full Text Links
  • JKSS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr