Malignant lymphomas of the thyroid gland: Analysis of 79 patients with emphasis on histologic prognostic factors

✍ Scribed by Katsuyuki Aozasa; Akifumi Inoue; Kazuo Tajima; Akira Miyauchi; Fumio Matsuzuka; Kanji Kuma

• Publisher: John Wiley and Sons
• Year: 1986
• Tongue: English
• Weight: 491 KB
• Volume: 58
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19860701)58:1<100::aid-cncr2820580118>3.0.co;2-1

✦ Synopsis

Prognostic factors in 79 patients with malignant lymphomas involving the thyroid gland were analyzed. These patients suffered from progressively enlarging goiter with over 6 months duration in 60% of patients. The age at operation ranged from 16 to 80 years (median, 58 years). Male to female ratio was 1A.8. Serum tests for antithyroid antibodies were positive in 83% of the patients, who also showed histologic evidence of chronic lymphocytic thyroiditis. Histologically, 52 cases (66%) were germinal center cell tumors with follicular or follicular and diffuse pattern in 9 cases. By the Working Formulation, 5-year survival rate of immunoblastic type (IBL) (13%) was much poorer than those of intermediate (79%) and low grade cases (92%) (P < 0.001). The cases of IBL usually had a goiter of short duration, and frequently presented as advanced disease.

Cuncer 58:lOO-104, 1986.

HYROID LYMPHOMA is a minor group of malignant

T lymphomas, and it contributed 2.5% in the series of Freeman and associates from North America' and 2.2% in our series from Japan.' Contrary to other types of lymphomas, in which males usually predominate females, female preponderance was marked in the thyroid lymphomas. This female preponderance was possibly due to origin of thyroid lymphomas from active lymphoid cells in chronic lymphocytic thyroiditis (CLTH), a disease that tends to occur in elderly women.3

The histologic differentiation of malignant lymphomas from severe CLTH or small cell carcinoma has been problematic. Recent report on a large series of cases of thyroid lymphomas and other lymphoproliferative disorders by Compagno and Oertel gave relative firm criteria to distinguish thyroid lymphomas from CLTH.4 Moreover opinion became popular that small cell tumors of the thyroid were really lymphomas, and presence of small cell carcinoma was negligible.4,5 From these recent findings,