MALT LYMPHOMA PRESENTING IN THE THYROID GLAND: A REPORT OF THREE CASES AT VIETNAM NATIONAL CANCER HOSPITAL
.
Abstract
Primary lymphoma presenting in the thyroid gland is rare, accounting for 2-8% of thyroid malignancies and 1-2% of extranodal malignancies. Mucosal lymphoid tissue-associated lymphoma (MALT) is one of the rare variants, first described by Isaacson and Wright in 1984. Primary MALT lymphoma of the thyroid gland accounts for 6-28% of tumors, closely related to chronic inflammatory or local autoimmune processes because thyroid tissue has no lymphatic organs. The coexistence between local inflammation and tumor formation causes many difficulties in disease diagnosis. Clinically, most patients are diagnosed at the age of over 60, with about 30% of patients having symptoms of local compression related to the tumor such as difficulty swallowing, shortness of breath, hoarseness. The standard treatment in MALT lymphoma is radiotherapy combined with chemotherapy; Surgery is valuable in diagnosis and symptom resolution. For asymptomatic patients regardless of stage who can be closely monitored, no treatment is required. In general, MALT lymphoma has a good prognosis, different from other histopathological types such as diffuse large B-cell lymphoma. Currently, there are not many reports on this clinical form, so we report 3 clinical cases, thereby drawing experience in the diagnosis and treatment of MALT lymphoma in the thyroid gland.
.
Keywords
primary thyroid lymphoma, MALT
- Shrestha P, Aderhold K, Swierczynski S, Lin C, Herb R. Primary thyroid MALToma– a rare diagnosis of an unassuming thyroid nodule. J Community Hosp Intern Med Perspect. 2018;8(1):42-45. doi:10.1080/20009666.2018.1424487
- Isaacson P, Wright DH. Malignant lymphoma of mucosa-associated lymphoid tissue. A distinctive type of B-cell lymphoma. Cancer. 1983;52(8):1410-1416. doi:10.1002/1097-0142(19831015)52:8<1410::aid-cncr2820520813>3.0.co;2-3
- Lee SC, Hong SW, Lee YS, et al. Primary thyroid mucosa-associated lymphoid tissue lymphoma; a clinicopathological study of seven cases. J Korean Surg Soc. 2011;81(6):374-379. doi:10.4174/jkss.2011.81.6.374
- Van Heertum RL, Scarimbolo R, Wolodzko JG, et al. Lugano 2014 criteria for assessing FDG-PET/CT in lymphoma: an operational approach for clinical trials. Drug Des Devel Ther. 2017;11:1719-1728. doi:10.2147/DDDT.S136988
- Kuper-Hommel MJJ, Snijder S, Jansen-Heijnen MLG, et al. Treatment and survival of patients with thyroid lymphoma: a population-based study with clinical and pathologic reviews. Clin Lymphoma Myeloma. 2005;6(3):240-247. doi:10.3816/clm.2005.n.052
- Munemasa M, Yoshino T, Kobayashi K, et al. Expression of thyroglobulin on follicular dendritic cells of thyroid mucosa-associated lymphoid tissue (MALT) lymphoma. Acta Med Okayama. 2009;63(2):71-78. doi:10.18926/AMO/31834
- Sangalli G, Serio G, Zampatti C, Lomuscio G, Colombo L. Fine needle aspiration cytology of primary lymphoma of the thyroid: a report of 17 cases. Cytopathology. 2001;12(4):257-263. doi:10.1046/j.1365-2303.2001.00338.x
- Nam YJ, Kim BH, Lee SK, et al. Co-Occurrence of Papillary Thyroid Carcinoma and Mucosa-Associated Lymphoid Tissue Lymphoma in a Patient with Long-Standing Hashimoto Thyroiditis. Endocrinol Metab (Seoul). 2013;28(4):341-345. doi:10.3803/EnM.2013.28.4.341
- Saito Y, Watanabe N, Suzuki N, et al. Role of Surgery in Patients with Stage IE Primary Thyroid MALT Lymphoma Staged by a Modified Classification System: The Tokyo Classification. Cancers (Basel). 2023;15(5):1451. doi:10.3390/cancers15051451
- Chen Q, Ayer T, Nastoupil LJ, et al. Initial management strategies for follicular lymphoma. Int J Hematol Oncol. 2012;1(1):35-45. doi:10.2217/ijh.12.7
- Thieblemont C, Cascione L, Conconi A, et al. A MALT lymphoma prognostic index. Blood. 2017;130(12):1409-1417. doi:10.1182/blood-2017-03-771915
