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Manda S, Tummidi S, Shankaralingappa A, Annam CS, Das S, Bakshi SS, Reddy PA. Primary Thyroid Lymphoma Diagnosed on Rapid Onsite and Cytology: A Rare Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:1040-1044. [PMID: 37275106 PMCID: PMC10235009 DOI: 10.1007/s12070-022-03326-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 11/29/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction Rapid on-site evaluation (ROSE) is an essential component of thyroid cytopathology, particularly important in thyroid lymphoma, anaplastic carcinoma, metastasis to avoid unnecessary surgery. Follicular epithelial neoplasms are the most common tumors arising from the thyroid, whereas primary thyroid lymphomas are uncommon, accounting for less than 5% of all thyroid malignancies. Case description A 45-year-old male patient presented to our ENT outpatient department with swelling in the anterior neck for 3 years duration. Non-aspirational needling was done along with rapid on-site evaluation using 1% aq. toluidine blue and was reported as Malignant thyroid neoplasm- possibility of Non-Hodgkin lymphoma (NHL). Cellblock sample also confirmed as B-cell NHL followed by Immunohistochemistry. Discussion Primary thyroid lymphomas (PTL) are uncommon malignant neoplasms. They represent < 5% of all thyroid malignancies and 1-2% of all extra-nodal lymphomas. If diagnosed cytologically, unnecessary surgery can be avoided in thyroid lymphoma. ROSE helps in the rapid diagnosis and sample adequacy. Cellblock can avoid the biopsy procedure used for confirmation and subtyping of lymphoma.
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Affiliation(s)
| | - Santosh Tummidi
- Department of Pathology and Lab Medicine, AIIMS, Kalyani, W.B. India
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Calle S, Choi J, Ahmed S, Bell D, Learned KO. Imaging of the Thyroid: Practical Approach. Neuroimaging Clin N Am 2021; 31:265-284. [PMID: 34243863 DOI: 10.1016/j.nic.2021.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Imaging evaluation of the thyroid gland spans a plethora of modalities, including ultrasound imaging, cross-sectional studies, and nuclear medicine techniques. The overlapping of clinical and imaging findings of benign and malignant thyroid disease can make interpretation a complex undertaking. We aim to review and simplify the vast current literature and provide a practical approach to the imaging of thyroid disease for application in daily practice. Our approach highlights the keys to differentiating and diagnosing common benign and malignant disease affecting the thyroid gland.
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Affiliation(s)
- Susana Calle
- Department of Neuroradiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street Unit 1482, Houston, TX 77030, USA.
| | - Jeanie Choi
- Neuroradiology Section, Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX 77030, USA
| | - Salmaan Ahmed
- Department of Neuroradiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street Unit 1482, Houston, TX 77030, USA
| | - Diana Bell
- Head and Neck Section, Departments of Pathology and Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Kim O Learned
- Department of Neuroradiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street Unit 1482, Houston, TX 77030, USA
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Hirokawa M, Suzuki A, Hashimoto Y, Satoh S, Canberk S, Jhuang JY, Jung CK, Tangnuntachai N, Kovacevic B, Zhu Y, Agarwal S, Kakudo K. Prevalence and diagnostic challenges of thyroid lymphoma: a multi-institutional study in non-Western countries. Endocr J 2020; 67:1085-1091. [PMID: 32641619 DOI: 10.1507/endocrj.ej20-0202] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Research on the primary thyroid lymphoma (PTL) diagnosis is limited, with only a few large sample size studies, reported from Asian countries. The aim of the present study was to clarify the current prevalence and challenges in PTL diagnosis, and recommended ancillary studies for PTL in non-Western countries. PTL (n = 153) cases were retrieved from 10 institutions in non-Western countries and analyzed. Ultrasound examination (UE) and fine needle aspiration cytology (FNAC) were used as main preoperative diagnostic tools in all participating institutions. Flow cytometry (FCM) was performed in the 5 institutions (50%). Lobectomy was the most common histological procedure to confirm the PTL diagnosis. All institutions routinely performed immuno-histochemical analysis. PTL was 0.54% of malignant thyroid tumor cases, with mucosa-associated lymphoid tissue lymphoma (MALTL) and diffuse large B-cell lymphoma (DLBCL) being 54.9% and 38.6%, respectively. Kuma Hospital, where the frequency of MALTL was highest (83.7%), routinely performed FCM using the materials obtained by FNAC. UE and FNAC sensitivities were 62.5% and 57.8%, respectively. In both UE and FNAC, sensitivity of MALTL was lower than of DLBCL. The study elucidated that the prevalence of PTL in non-Western countries was lower than previously reported. We propose that FCM should be more actively used to improve the preoperative diagnosis of MALTL. Our data predicted that the MALTL proportion will increase with improved diagnostic tools, while observation of PTL-suspected nodules without histological examination remains a viable option.
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MESH Headings
- Biopsy, Fine-Needle
- China/epidemiology
- Humans
- Immunohistochemistry
- India/epidemiology
- Japan/epidemiology
- Lymphoma/diagnosis
- Lymphoma/epidemiology
- Lymphoma/pathology
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/epidemiology
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, Follicular/diagnosis
- Lymphoma, Follicular/epidemiology
- Lymphoma, Follicular/pathology
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/epidemiology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Prevalence
- Republic of Korea/epidemiology
- Serbia/epidemiology
- Taiwan/epidemiology
- Thailand/epidemiology
- Thyroid Neoplasms/diagnosis
- Thyroid Neoplasms/epidemiology
- Thyroid Neoplasms/pathology
- Thyroidectomy
- Turkey/epidemiology
- Ultrasonography
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Affiliation(s)
| | - Ayana Suzuki
- Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe, Japan
| | - Yuko Hashimoto
- Department of Diagnostic Pathology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shinya Satoh
- Department of Endocrine Surgery, Yamashita Thyroid Hospital, Fukuoka, Japan
| | - Sule Canberk
- Department of Pathology, Subdivision of Cytopathology, Acibadem University, Istanbul, Turkey
- Cancer Signaling & Metabolism, IPATIMUP/Instituto de Investigação e Inovação em Saúde, Universidade do Porto Rua Alfredo Allen, Porto, Portugal
| | - Jie Yang Jhuang
- Department of Pathology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chan Kwon Jung
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | | | - Bozidar Kovacevic
- Institute of Pathology and Forensic Medicine, Military Medical Academy, Belgrade, Serbia
| | - Yun Zhu
- Department of Pathology, Jiangsu Institute of Nuclear Medicine, Wuxi, China
| | - Shipra Agarwal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Kennichi Kakudo
- Department of Pathology and Thyroid Disease Center, Izumi City General Hospital, Izumi, Japan
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