Spontaneous Regression Of Primary Thyroid Lymphoma: Two Rarities At The Same Time
Illán-Gambín, F., Manresa-Manresa, P., Rodríguez-Aleo, E., & Aranda-López, I. (2020). Spontaneous Regression of Primary Thyroid Lymphoma: Two Rarities at the Same Time. Spontaneous Regression of Primary Thyroid Lymphoma: Two Rarities at the Same Time. Turk patoloji dergisi, 36(2), 164–168. https://doi.org/10.5146/tjpath.2018.01445
View Original Source →Abstract
Primary thyroid lymphomas are pretty uncommon, and constitute about 5% of the neoplasms of this organ. Spontaneous tumor regression is defined as the total or partial disappearance of a tumor as proven by microscope without treatment or under inadequate treatment. It is estimated to happen in one out of 60,000-100,000 cases. We present a case of primary thyroid lymphoma with spontaneous regression after diagnostic puncture and corroborated with hemithyroidectomy at four months. The patient died after twenty-six months of follow-up because of endocarditis and there was no relapse at any time.
Case Details
Disease Location
Thyroid
Personal Characteristics
63-year-old woman, surgically treated for tonsils in childhood and for her gallbladder due to stones, and for aortic-mitral double replacement at 40 years secondary to endocarditis. She was anticoagulated with warfarin
Clinical Characteristics
She noted a nodule in the front of the neck that became visible. Ultrasound showed a right thyroid lobe replaced by a solid and heterogeneous tumor of 4.4 x 3.4 cm with ill-defined contours and abnormal vascularization with doppler. The patient underwent needle biopsy. It showed a diffuse infiltrate of large lymphoid cells with lobulated nuclei, marked nucleoli, frequent mitosis and apoptosis. After immunohistochemical evaluation, the lymphoid nature of the neoplasm (CD45 +) was confirmed. The diagnosis of primary thyroid diffuse large b-cell lymphoma, germinal center b-cell subtype was made. A hemithyroidectomy was carried out five months after the first fna. The right hemithyroid had regular weight and dimensions and whitish fibrous bands without defined solid nodules
Remission Characteristics
Two months after the first fna, a clinical decrease of tumor dimensions was observed. A new biopsy was taken showing thyroid follicles, fibrous tracts and non-atypical small lymphocytes. Microscopic examination of the hemithyroidectomy showed no neoplastic population
Treatment & Mechanisms
Proposed Remission Mechanisms
Biopsy started the t-lymphocyte response and resulted in complete str.
Clinical Treatment
Biopsy hemithyroidectomy
Non-Clinical Treatment
None reported