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Primary thyroid lymphoma: Can the diagnosis be made solely by fine-needle aspiration?

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Abstract

Background

Primary malignant lymphoma fo the thyroid accounts for <5% of all thyroid malignancies and is primarily treated with chemotherapy and external beam radiation. With the advent of modern immunophenotypic analyses, fine-needle aspiration (FNA) can potentially obviate the need for surgical procedures.

Methods

To investigate the utility of FNA, data from 23 consecutive patients with primary malignant thyroid lymphoma evaluated at the Johns Hopkins Hospital from July 1985 to April 2000 were analyzed.

Results

Patients were categorized into two groups: those diagnosed before 1993 (group 1, n=12) and those diagnosed after 1993 (group 2, n=11). Although patients in group 1 were slightly older, there were no other differences between the groups with regard to sex, tumor grade, or tumor stage. Although no patient in group 1 was successfully diagnosed by FNA alone, seven patients (63%) in group 2 were diagnosed solely by FNA (P=.019, χ2 analysis). Therefore, all 12 patients in group 1, but only 4 of 11 patients in group 2, required open surgical biopsy.

Conclusions

Primary thyroid lymphoma is an uncommon malignancy usually treated nonsurgically once the diagnosis is established. In most patients with malignant lymphoma of the thyroid, FNA, should obviate the need for open surgical biopsy.

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References

  1. Compagno, J., Oertel JE. Malignant lymphoma and other lympho-proliferative disorders of the thyroid gland. A clinicopathologic study of 245 cases.Am J Clin Pathol 1980;74:1–11.

    PubMed  CAS  Google Scholar 

  2. Doria R, Jewkel JF, Cooper DL. Thyroid lymphoma. The case for combined modality therapy.Cancer 1994;73:200–6.

    Article  PubMed  CAS  Google Scholar 

  3. Tsang RW, Gospodarowicz MK, Sutcliffe SB, et al. Non Hodgkin's lymphoma of the thyroid gland: prognostic factors and treatment outcome. The Princess Margaret Hospital Lymphoma GroupInt J Radiat Oncol Biol. Physiol 1993;27:599–604.

    Article  CAS  Google Scholar 

  4. ansell SM, Grant CS, Habermann TM. Primary thyroid lymphoma.Semin Oncol 1999;26:316–23.

    PubMed  CAS  Google Scholar 

  5. Udelsman R, Chen H. The current management of thyroid cancer.Adv Surg 1999;33:1–27.

    PubMed  CAS  Google Scholar 

  6. Pasieka JL. Hashimoto's disease and thyroid lymphoma: role of the surgeon.World J surg 2000;24:966–70.

    Article  PubMed  CAS  Google Scholar 

  7. Kossev P, Livolsi V. Lymphoid lesions of the thyroid: review in light of the revised European-American lymphoma classification and upcoming World Health Organization classification.Thyroid 1999;9:1273–80.

    PubMed  CAS  Google Scholar 

  8. Fonseca E, Sambade C. Primary lymphomas of the thyroid gland: a review with emphasis on diagnostic features.Arch Anat Cytol Pathol 1998;46:94–9.

    PubMed  CAS  Google Scholar 

  9. Laing RW, Hoskin P, Hudson BV, et al. The significance of MALT histology in thyroid lymphoma: a review of patients from the BNLI and Royal Marsden Hospital.Clin Oncol 1994;6:300–4.

    Article  CAS  Google Scholar 

  10. Anscombe AM, Wright DH. Primary malignant lymphoma of the thyroid—a tumour of mucosa-associated lymphoid tissue: review of seventy-six cases.Histopathology 1985;9:81–97.

    Article  PubMed  CAS  Google Scholar 

  11. Isaacson P, Wright DH. Extranodal malignant lymphoma arising from mucosa-associated lymphoid tissue.Cancer 1984;53:2515–24.

    Article  PubMed  CAS  Google Scholar 

  12. Skarsgard ED, Connors JM, Robins RE. A current analysis of primary lymphoma of the thyroid.Arch Surg 1991;126:1199–203; discussion, 1203–4.

    PubMed  CAS  Google Scholar 

  13. Matsuzuka F, Miyauchi A, Katayama S, et al. Clinical aspects of primary thyroid lymphoma: diagnosis and treatment based on our experience of 119 cases.Thyroid 1993;3:93–9.

    PubMed  CAS  Google Scholar 

  14. Young NA, Al-Saleem TI, Ehya H, Smith MR. Utilization of fine-needle aspriation cytology and flow cytometry in the diagnosis and subclassification of primary and recurrent lymphoma.Cancer 1998:84:252–61.

    Article  PubMed  CAS  Google Scholar 

  15. Young NA, Al-Saleem T. Diagnosis of lymphoma by fine-needle aspiration cytology using the revised European-American classification of lymphoid neoplasms.Cancer 1999:87:325–45.

    Article  PubMed  CAS  Google Scholar 

  16. Jeffers MD, Milton J, Herriot R, McKean M. Fine needle aspiration cytology in the investigation on non-Hodgkin's lymphoma.J Clin Pathol 1998;51:189–96.

    Article  PubMed  CAS  Google Scholar 

  17. Sneige N, Dekmezian R, el-Naggar A, Manning J. Cytomorphologic, immunocytochemical, and nucleic acid flow cytometric study of 50 lymph, nodes by fine-needle aspiration. Comparison with results obtained by subsequent excisional biopsy.Cancer 1991;67:1003–7.

    Article  PubMed  CAS  Google Scholar 

  18. Dunphy CH, Ramos R. Combining fine-needle aspiration and flow cytometric immunophenotyping in evaluation of nodal and extranodal sites for possible lymphoma: a retrospective review.Diagn Cytopathol 1997;16:200–6.

    Article  PubMed  CAS  Google Scholar 

  19. Pyke CM, Grant CS, Habermann TM, et al. Non-Hodgkin's lymphom of the thyroid: is more than biopsy necessary?.World J Surg 1992;6:604–9; discussion, 609–10.

    Article  Google Scholar 

  20. Yamaguchi M, Ohno T, Kita K. gamma/delta, T-cell lymphoma of the thyroid gland (letter).N Engl J Med 1997;336:1391–2.

    Article  PubMed  CAS  Google Scholar 

  21. Abdul-Rahman ZH, Gogas HJ, Tooze JA, et al. T-cell lymphoma in Hashimoto's thyroiditis.Histopathology 1996;29:455–9.

    Article  PubMed  CAS  Google Scholar 

  22. Holm LE, Blomgren H, Lowhagen T. Cancer risks in patients with chronic lymphocytic thyroiditis.N Engl J Med 1985;321:601–4.

    Article  Google Scholar 

  23. Aozasa K, Ueda T, Katagiri S, et al. Immunologic and immunohistologic analysis of 27 cases with thyroid lymphomas.Cancer 1987;60:969–73.

    Article  PubMed  CAS  Google Scholar 

  24. Campbell DJ, Sage RH. Thyroid cancer: twenty years' experience in a general hospital.Br J Surg 1975;62:207–14.

    Article  PubMed  CAS  Google Scholar 

  25. Hamburger JI, Miller JM, Kini SR. Lymphoma of the thyroid.Ann. Intern Med 1983;99:685–93.

    PubMed  CAS  Google Scholar 

  26. Rasbach DA, Mondschein MS, Harris NL, et al.. Malignant lymphoma of the thyroid gland: a clinical and pathologic study of twenty cases.Surgery 1985;98:1166–70.

    PubMed  CAS  Google Scholar 

  27. Junor EJ, Paul J, Reed NS. Primary non-Hodgkin's lymphoma of the thyroid.Eur J Surg Oncol 1992;18:313–21.

    PubMed  CAS  Google Scholar 

  28. Friedberg MH, Coburn MC, Monchik JM. Role of surgery in stage IE non-Hodgkin's lymphoma of the thyroid.Surgery 1994;116: 1061–6; discussion, 1066–7.

    PubMed  CAS  Google Scholar 

  29. 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;12:1807–12.

    PubMed  CAS  Google Scholar 

  30. Connors JM, Klimo P, Fairey RN, Voss N. Brief chemotherapy and involved field radiation therapy for limited-stage, histologically aggressive lymphoma.Ann Intern Med 1987;107:25–30.

    PubMed  CAS  Google Scholar 

  31. Sasai K, Yamabe H, Haga H, et al.. Non-Hodgkin's lymphoma of the thyroid. A clinical study of twenty-two cases.Acta Oncol 1996;35:457–62.

    PubMed  CAS  Google Scholar 

  32. Devine RM, Edis AJ, Banks PM. Primary lymphoma of the thyroid: a review of the Mayo Clinic experience through 1978.World J Surg 1981;5:33–8.

    Article  PubMed  CAS  Google Scholar 

  33. Roeher HD, Simon D. Surgical therapy of thyroid cancer.G Chir 1999;20:5–8.

    PubMed  CAS  Google Scholar 

  34. Klyachkin ML, Schwartz RW, Cibull M, et al. Thyroid lymphoma: is there a role for surgery?.Am Surg 1998;64:234–8.

    PubMed  CAS  Google Scholar 

  35. Wakely PE Jr. Aspiration cytopathology of malignant lymphoma: coming of age.Cancer 1999;87:322–4.

    Article  PubMed  Google Scholar 

  36. A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin's lymphma. The Non-Hodgkin's Lymphoma Classification Project.Blood 1997;89:3909–18.

    Google Scholar 

  37. 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:S8–12.

    Google Scholar 

  38. Kaleem A, Davila RM, Ryan MR, et al. Diagnostic role of flow cytometry in fine needle aspiration biopsy of lymph nodes performed for suspected lymphoma [Abstract].Mod Pathol 1999;12: 46A.

    Google Scholar 

  39. Matsuda M, Sone H, Koyama H, Ishiguro S. Fine-needle aspiration cytology of malignant lymphoma of the thyroid.Diagn Cytopathol 1987;3:244–9.

    Article  PubMed  CAS  Google Scholar 

  40. Detweiler RE, Katz RL, Alapat C, et al. Malignant lymphoma of the thyroid: a report of two cases diagnosed by fine-needle aspiration.Diagn Cytopathol 1991;7:163–71.

    Article  PubMed  CAS  Google Scholar 

  41. Arnold A, Cossman J, Bakhshi A, et al. Immunoglobulin-gene rearrangements as unique clonal markers in human lymphoid neoplasms.N Engl J Med 1983;309:1593–9.

    Article  PubMed  CAS  Google Scholar 

  42. Joensuu H, Klemi PJ, Eerola E. Diagnostic value of DNA flow cytometry combined with fine needle aspiration biopsy in lymphomas.J Pathol 1988;154:237–45.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin

    Charles Cha MD & Herbert Chen MD

  2. Department of Surgery (WHW), Johns Hopkins Hospital, Baltimore, Maryland

    William H. Westra MD

  3. Department of Pathology (RU), Johns Hopkins Hospital, Baltimore, Maryland

    Robert Udelsman MD

Authors
  1. Charles Cha MD
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  2. Herbert Chen MD
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  3. William H. Westra MD
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  4. Robert Udelsman MD
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Correspondence to Herbert Chen MD.

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Cha, C., Chen, H., Westra, W.H. et al. Primary thyroid lymphoma: Can the diagnosis be made solely by fine-needle aspiration?. Annals of Surgical Oncology 9, 298–302 (2002). https://doi.org/10.1007/BF02573069

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  • DOI: https://doi.org/10.1007/BF02573069

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