Synchronous Occurrence of Papillary Thyroid Carcinoma and Mucosa-Associated Lymphoid Tissue Lymphoma: a Single Case Report

Jun Suk Byun; Hye Yoon Lee; Ki Won Chun; Dae Sung Yoon

doi:10.11106/ijt.2016.9.2.195

Journal List > Int J Thyroidol > v.9(2) > 1082747

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Byun, Lee, Chun, and Yoon: Synchronous Occurrence of Papillary Thyroid Carcinoma and Mucosa-Associated Lymphoid Tissue Lymphoma: a Single Case Report

Case Report

Int J Thyroidol 2016;9(2):195-199.

Published online: 20 November 2016

DOI: https://doi.org/10.11106/ijt.2016.9.2.195

Synchronous Occurrence of Papillary Thyroid Carcinoma and Mucosa-Associated Lymphoid Tissue Lymphoma: a Single Case Report

Jun Suk Byun, Hye Yoon Lee, Ki Won Chun, Dae Sung Yoon

Department of Surgery, Konyang University Hospital, Daejeon, Korea

Correspondence: Dae Sung Yoon, MD, PhD, Department of Surgery, Center of Breast and Thyroid Cancers, Konyang University Hospital, 158 Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea Tel: 82-42-600-8956, Fax: 82-42-524-8956, E-mail: dsyoonmd@kyuh.ac.kr

Received 25 April 2016 Revised 23 June 2016 Accepted 4 September 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Papillary thyroid carcinoma (PTC) is a common lesion, accounting for 70–80% of all thyroid cancers, whereas mucosa-associated lymphoid tissue (MALT) lymphoma of thyroid gland is rare. A simultaneous occurrence of both malignancies is extremely rare. 57 years old Korean woman diagnosed with Hashimoto' s thyroiditis at left lobe of thyroid gland where atypical cells of undetermined significance at right lobe. Later, left lobe was confirmed with malignant lymphoma during series of fine-needle aspiration biopsy. Right lobe was interpreted as malignant lesions, such as papillary thyroid carcinoma based on ultrasonography images and previous biopsy results. Total thyroidectomy was performed. Pathology reported papillary thyroid carcinoma at right lobe and MALT lymphoma at left lobe. There were no post-operative complications and no recurrence yet reported. Since an association between Hashimoto' s thyroiditis and development of MALT lymphoma has been reported previously, a history of Hashimoto thyroiditis should be suspected MALT lymphoma.

Keywords: Papillary thyroid carcinoma, Mucosa-associated lymphoid tissue lymphoma of the thyroid gland, Hashimoto's thyroiditis

References

1. Melo GM, Sguilar DA, Petiti CM, Eichstaedt AG, Caiado RR, Souza RA. Concomitant thyroid MALT lymphoma and papillary thyroid carcinoma. Arq Bras Endocrinol Metabol. 2010; 54(4):425–8.

2. Cheng V, Brainard J, Nasr C. Co-occurrence of papillary thyroid carcinoma and primary lymphoma of the thyroid in a patient with long-standing Hashimoto's thyroiditis. Thyroid. 2012; 22(6):647–50.

3. Tarui T, Ishikawa N, Kadoya S, Watanabe G. Co-occurrence of papillary thyroid cancer and MALT lymphoma of the thyroid with severe airway obstruction: a case report and review of the literature. Int J Surg Case Rep. 2014; 5(9):594–7.

4. Thieblemont C, Mayer A, Dumontet C, Barbier Y, Callet-Bauchu E, Felman P, et al. Primary thyroid lymphoma is a heterogeneous disease. J Clin Endocrinol Metab. 2002; 87(1):105–11.

5. 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(1 Suppl 1):S8–12.

6. Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Cleary ML, et al. A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood. 1994; 84(5):1361–92.

7. Hyjek E, Isaacson PG. Primary B cell lymphoma of the thyroid and its relationship to Hashimoto's thyroiditis. Hum Pathol. 1988; 19(11):1315–26.

8. Nam YJ, Kim BH, Lee SK, Jeon YK, Kim SS, Jung WJ, et al. Co-occurrence of papillary thyroid carcinoma and mucosaassociated lymphoid tissue lymphoma in a patient with longstanding hashimoto thyroiditis. Endocrinol Metab (Seoul). 2013; 28(4):341–5.

9. Matsuzuka F, Miyauchi A, Katayama S, Narabayashi I, Ikeda H, Kuma K, et al. Clinical aspects of primary thyroid lymphoma: diagnosis and treatment based on our experience of 119 cases. Thyroid. 1993; 3(2):93–9.

10. Tsang RW, Gospodarowicz MK, Pintilie M, Wells W, Hodgson DC, Sun A, et al. Localized mucosa-associated lymphoid tissue lymphoma treated with radiation therapy has excellent clinical outcome. J Clin Oncol. 2003; 21(22):4157–64.

11. Kahara T, Iwaki N, Kaya H, Kurokawa T, Yoshida T, Ishikura K, et al. Transition of thyroid autoantibodies by rituximab treatment for thyroid MALT lymphoma. Endocr J. 2011; 58(1):7–12.

12. Pfreundschuh M, Schubert J, Ziepert M, Schmits R, Mohren M, Lengfelder E, et al. Six versus eight cycles of bi-weekly CHOP-14 with or without rituximab in elderly patients with aggressive CD20+ B-cell lymphomas: a randomised controlled trial (RICOVER-60). Lancet Oncol. 2008; 9(2):105–16.

13. Lee SC, Hong SW, Lee YS, Jeong JJ, Nam KH, Chung WY, et al. Primary thyroid mucosa-associated lymphoid tissue lymphoma; a clinicopathological study of seven cases. J Korean Surg Soc. 2011; 81(6):374–9.

Fig. 1.

Ultrasonography for the thyroid gland revealed the diffuse enlarged left lobe of the thyroid gland with 0.8 cm size of hypoechoic nodule (arrow) whereas about 0.5 cm size of irregular shaped hypoechoic nodule found near the right side of the isthmus (circle).

Fig. 2.

Enhanced computed tomography (CT) revealed small nodular lesion appeared adjacent to the right side of isthmus (arrow) whereas the left lobe of the thyroid gland and the isthmus involving with lymphoma showed diffusely enlargement and abnormal enlarged lymph nodes involving left level IV, VI and supraclavicular area (circle).

Fig. 3.

(A) Histologic section of papillary microcarcinoma in background of lymphocytic thyroiditis (H&E stain, ×100). (B) Extranodal marginal zone B-cell lymphoma involving thyroid. Low-power magnification exhibiting a follicular pattern mimicking follicular lymphoma (H&E stain, ×40). (C) Sheets of monocytoid cells and lymphoepithelial lesion (LEL) (H&E stain, ×400). (D) Bcl2-negative germinal centers, excluding follicular lymphoma (Immunohistolochemistry, ×40). (E) CD20-abnormal aggregates of neoplastic B-cells in interfollicular space (immunohistolochemistry, ×40). (F) CK-destructive lymphoid infiltration accompanied by marked lymphoid hyperplasia (immunohistolochemistry, ×40).

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