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Diffuse large B-cell lymphoma of the thyroid which caused esophageal fistula

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Abstract

We describe a rare case of thyroidal Epstein–Barr virus-positive diffuse large B-cell lymphoma of the elderly (EBV+DLBCLe) in which diagnosis was difficult and spontaneous esophageal fistula developed. A 79-year-old woman presented with acute swelling of the anterior neck with tenderness, general fatigue, and continual fever. Malignant lymphoma of the thyroid was suspected. Histologically, the thyroid lesion showed extensive necrosis, including a few Ziehl–Neelsen-positive substances. No evidence of tuberculosis was detected by any other examinations. While performing examinations, left recurrent nerve palsy and a tumorous lesion in the pharynx appeared. Computed tomography and gastrointestinal fiberscopy revealed esophageal fistula. Biopsy specimens from the pharyngeal lesion showed diffuse proliferation of large atypical lymphoid cells that were strongly positive for CD20 and EBV early RNAs. The final diagnosis was thyroidal EBV+DLBCLe with infiltration of surrounding organs. The esophageal fistula had healed 6 months after beginning treatment of EBV+DLBCLe.

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Ethical Statement

The work reported in the manuscript entitled “Diffuse large B-cell lymphoma of the thyroid which caused esophageal fistula” did not involve any studies performed with human or animal subjects by any authors.

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Authors and Affiliations

  1. Department of Otolaryngology, Himeji Red Cross Hospital, Himeji, Japan

    Tomoyasu Tachibana, Yuya Ogawara, Yuko Matsuyama & Iku Abe

  2. Department of Otolaryngology, Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan

    Yorihisa Orita & Kazunori Nishizaki

  3. Department of Pathology, Himeji Red Cross Hospital, Himeji, Japan

    Masayoshi Fujisawa & Kaori Uchino

  4. Department of Internal Medicine, Himeji Red Cross Hospital, Himeji, Japan

    Yasushi Hiramatsu, Hirofumi Morishita & Koichi Uesaka

  5. Department of Surgery, Himeji Red Cross Hospital, Himeji, Japan

    Tetsuji Nobuhisa

  6. Department of Otolaryngology, Head and Neck Surgery, Himeji Red Cross Hospital, 12-1 Shimoteno, 1 Cho-me, Himeji, Hyogo, 670-8540, Japan

    Tomoyasu Tachibana

Authors
  1. Tomoyasu Tachibana
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  2. Yorihisa Orita
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  3. Masayoshi Fujisawa
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  4. Yasushi Hiramatsu
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  5. Yuya Ogawara
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  6. Yuko Matsuyama
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  7. Iku Abe
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  8. Kaori Uchino
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  9. Hirofumi Morishita
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  10. Tetsuji Nobuhisa
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  11. Koichi Uesaka
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  12. Kazunori Nishizaki
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Correspondence to Tomoyasu Tachibana.

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Tachibana, T., Orita, Y., Fujisawa, M. et al. Diffuse large B-cell lymphoma of the thyroid which caused esophageal fistula. Esophagus 12, 77–81 (2015). https://doi.org/10.1007/s10388-013-0408-2

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  • DOI: https://doi.org/10.1007/s10388-013-0408-2

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