Thyroid Lymphoma Flashcards
Thyroid lymphoma- basic demographics
fewer than 5% of malignancies
- women > men (4:1 ratio)
- majority are non-Hodgkin’s lymphomas of B-cell origin
- 50% of lymphomas arise from background of pre-existing Hashimoto’s thyroiditis
- subgroup of MALT
Clinical presentation thyroid lymphoma
rapidly enlarging thyroid mass and compressive symptoms
history of hypothyroidism (remember association with Hashimoto’s)
-few patients have B symptoms
-diagnosis considered in patients with goiter
Work-up of thyroid lymphoma
CT neck, chest, abdo with or without PET
-if FNA not diagnostic, then core needle biopsy
Management of thyroid lymphoma
diffuse large B cell lymphoma CHOP chemotherapy followed by radiation for stage IE or IIE disease C- cyclophosphamide H- hydroxydanorubocin (Doxorubin) O- oncovin (Vincristine) P- prednisone
Role of surgery in thyroid lymphoma
surgery generally not required but subset of patients with significant compressive symptoms from big tumours could benefit from palliative total or subtotal thyroidectomy
-can use surgery for diagnostic biopsy when diagnosis cannot be made by FNAB or CNB