Is it Anaplastic Thyroid Cancer, Primary Thyroid Lymphoma, or Rosai Dorfman Disease? An Elusive Histopathologic Diagnosis of a Thyroid Mass

Author(s):  
Stephanie Kim ◽  
Austin L. Gray ◽  
Wilson P. Lao ◽  
Mia N. Perez ◽  
Yan Liu ◽  
...  
Praxis ◽  
2021 ◽  
Vol 110 (14) ◽  
pp. 812-815
Author(s):  
Dea Degabriel ◽  
Alberto Cerutti ◽  
Laura Caramanica ◽  
Alessandro Viganò ◽  
and Tanja Fusi-Schmidhauser

Abstract. We present the case of a 72-year-old woman who was diagnosed with Hashimoto’s thyroiditis and who developed a low-grade fever, fatigue, and weight loss that prompted to perform a thyroid biopsy to rule out an underlying primary thyroid lymphoma. This case report offers the opportunity to review the association between Hashimoto’s thyroiditis and primary thyroid lymphoma. Furthermore, it underlines the importance of considering the diagnosis of lymphoma when a thyroid mass is found in patients with an underlying Hashimoto’s disease, as the timely management is essential for survival with this rare thyroid condition.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Yoshinori Yasuda ◽  
Fabiana Pani ◽  
Patrizio Caturegli

Abstract Primary thyroid lymphoma is rare, accounting for less than 5% of all thyroid malignancies. It typically develops in patients with Hashimoto thyroiditis who have approximately a 70 fold higher risk than other patients. The mechanisms underlying the development of thyroid lymphoma remain unclear, and no mouse model has been described. For our studies of papillary thyroid cancer and lymphocytic thyroiditis, we crossed TPO-Cre-ER transgenic mice and hBRAFV600E knock-in mice onto the NOD.H2h4 background to establish TPO-Cre-ER_ hBRAFV600E NOD.H2h4 strain where papillary thyroid cancer is induced by the injection of tamoxifen and thyroiditis by the administration of iodine in the drinking water. Mice injected with corn oil or drinking regular water served as control. In 3 of 121 mice, TPO-Cre-ER_ hBRAFV600E NOD.H2h4 mice injected with corn oil and drinking iodinated water we observed the development of thyroid lymphoma. At about 6 months after the injection of corn oil, these mice developed a marked increase in the size of the thyroid gland, which appeared hypoechoic on thyroid ultrasound. Fine needle aspiration on the thyroid gland under ultrasound was performed, along with measurement of TPO antibodies, H&E thyroid histology, immunohistochemistry, and flow cytometry at the time of sacrifice. Histology established a diagnosis of Hodgkin lymphoma with the typical Reed Sternberg cells. Flow cytometry identified an increased frequency of CD8+ effector memory T cells in the thyroid lymphoma. TPO antibodies were significantly higher in mice with thyroid lymphoma than in those without, perhaps suggesting their utility as predictive biomarkers. In summary, we report a mouse model of thyroid lymphoma that evolves from a background of lymphocytic thyroiditis with a predictable natural course that can be monitored by thyroid ultrasound and TPO antibodies. This model can be used to study the mechanisms and development of thyroid lymphoma in patients.


2015 ◽  
Vol 26 (4) ◽  
pp. 1031-1036 ◽  
Author(s):  
Eun Ju Ha ◽  
Jung Hwan Baek ◽  
Jeong Hyun Lee ◽  
Jae Kyun Kim ◽  
Dong Eun Song ◽  
...  

2020 ◽  
pp. 1-5
Author(s):  
Yeleni Eelen ◽  
Jaques van Heerden ◽  
Joris Verlooy ◽  
Koen Norga ◽  
Thomas Tousseyn ◽  
...  

Background: Primary thyroid lymphoma is extremely rare in children and adolescents. The diagnosis of thyroid malignancies is often made secondary to other thyroid pathologies including Hashimoto’s thyroiditis (HT). Case Presentation: This case describes a 14-year-old girl with a background of HT and congenital deafness that presented with a rapidly enlarging multinodular thyroid mass. She underwent a total thyroidectomy and a diffuse, large B-cell lymphoma was diagnosed on pathology. Discussion: Primary thyroid disease is an extremely rare disease in childhood, usually presenting as a rapidly enlarging goitre. The correlation between Hashimoto’s thyroiditis and primary thyroid lymphoma is well-established in adults but has not been verified in the paediatric population. Our patient also has βthalassemia and Usher syndrome, however, no correlation between these and primary thyroid lymphoma could be found in the literature. Conclusion: It is important to include malignancy in the differential diagnosis of thyroid enlargement or unexplained symptoms, especially in the presence of syndromes. Further research into the relation between lymphomas and HT in the paediatric population is needed.


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