Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

A Current Analysis of Primary Lymphoma of the Thyroid

A Current Analysis of Primary Lymphoma of the Thyroid Abstract • Over a 9-year period ending in May 1990, 27 patients with histologically proved thyroid lymphoma were assessed and treated. There were 24 female and three male patients with a median age of 67 years at the time of diagnosis (age range, 39 to 85 years). The usual presentation was that of a rapidly enlarging neck mass. Incisional biopsy was the diagnostic procedure of choice; however, nine of 27 patients underwent diagnostic partial or total thyroidectomy based on a preoperative impression of thyroid carcinoma. All 27 patients had non-Hodgkin's lymphomas of intermediate (77%) or high (23%) grade. Detailed staging was carried out in 25 patients; seven patients (28%) had disease confined to the thyroid gland (stage I), while 18 (73%) had accompanying disease in cervical lymph nodes or the mediastinum (stage II). Combined multiagent chemotherapy and irradiation was given to 19 of 25 staged patients (76%). Actuarial, overall 5-year survival for all patients was 70% with 48 months being the median follow-up for living patients (follow-up range, 3 to 102 months). Of a number of factors evaluated using log-rank survival tests, only the absence of dysphagia at the time of hospital admission, a primary tumor mass not greater than 10 cm, restriction of disease to the thyroid gland, and the absence of mediastinal lymph node involvement were statistically significant predictors of improved survival. Surgery should usually be restricted to diagnostic biopsy, as there is infrequently a role for resection in the management of thyroid lymphoma, given the effectiveness of combined multiagent chemotherapy and radiotherapy. (Arch Surg. 1991; 126:1199-1204) References 1. Staunton HD, Greening WP. Clinical diagnosis of thyroid cancer . BMJ . 1973;4:532-535.Crossref 2. Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas . Cancer . 1972;29:252-260.Crossref 3. Burke JS, Butler JJ, Faller LM. Malignant lymphoma of the thyroid: a clinical pathologic study of 35 patients including ultrastructural observations . Cancer . 1977;39:1587-1601.Crossref 4. Grimley RP, Oates GD. The natural history of malignant thyroid lymphomas . Br J Surg . 1980;67:475-477.Crossref 5. Souhami L, Simpson WJ, Carruthers JS. Malignant lymphoma of the thyroid gland . Int J Radiat Oncol Biol Phys . 1980;6:1143-1147.Crossref 6. Goudie R, Angouridakis CE. Autoimmune thyroiditis associated with malignant lymphoma of the thyroid . J Clin Pathol . 1970;23:377-381.Crossref 7. Hamburger JI, Miller JM, Kini SR. Lymphoma of the thyroid . Ann Intern Med . 1983;99:685-693.Crossref 8. Devine RM, Edis AJ, Banks PM. Primary lymphoma of the thyroid: a review of the Mayo Clinic experience through 1978 . World J Surg . 1981;5:33-38.Crossref 9. Aozasa K, Inoue A, Tajima K, Miyauchi A, Matsuzuka F, Kuma K. Malignant lymphomas of the thyroid gland: analysis of 79 patients with emphasis on histological prognostic factors . Cancer . 1986;58:100-104.Crossref 10. Meissner WA, Phillips MJ. Diffuse small cell carcinoma of the thyroid . Arch Pathol Lab Med . 1962;74:291-297. 11. Compagno J, Oertel JE. Malignant lymphoma and other lymphoproliferative disorders of the thyroid gland: a clinico-pathologic study of 245 cases . Am J Clin Pathol . 1980;74:1-11. 12. Rosen IB, Sutcliffe SB, Gospodarowicz MK, Chua T, Simpson WJ. The role of surgery in the management of thyroid lymphoma . Surgery . 1988;104:1095-1099. 13. Carbone PP, Kaplan HS, Musshoff K, Smither DW, Tubiana M. Report of the committee on Hodgkin's disease staging classification . Cancer Res . 1971;31:1860-1861. 14. Sirota DK, Segal RL. Primary lymphomas of the thyroid gland . JAMA . 1979;242:1743-1746.Crossref 15. Chak LY, Hoppe RT, Burke JS, Kaplan HS. Non-Hodgkin's lymphoma presenting as thyroid enlargement . Cancer . 1981; 48:2712-2716.Crossref 16. Esselstyn CB, Crile G. Evaluation of various types of needle biopsies of the thyroid . World J Surg . 1984;8:452-457.Crossref 17. Vigliotti A, Kong JS, Fuller LM, Velasquez WS. Thyroid lymphomas stages IE and IIE: comparative results for radiotherapy only, combination chemotherapy only, and multimodality treatment . Int J Radiat Oncol Biol Phys . 1986;12:1807-1812.Crossref 18. Tupchong L, Hughes F, Harmer CL. Primary lymphoma of the thyroid: clinical features, prognostic factors, and results of treatment . Int J Radiat Oncol Biol Phys . 1986;12:1813-1821.Crossref 19. Blair TJ, Evans RG, Buskirk SJ, Banks PM, Earle JD. Radiotherapeutic management of primary thyroid lymphoma . Int J Radiat Oncol Biol Phys . 1985;11:365-370.Crossref 20. Aozasa K, Inoue A, Yoshimuru H, et al. Intermediate lymphocytic lymphoma of the thyroid: an immunologic and immunohistologic study . Cancer . 1986;57:1762-1767.Crossref 21. Shimkin PM, Sagerman RH. Lymphoma of the thyroid gland . Radiology . 1969;92:812-816.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

A Current Analysis of Primary Lymphoma of the Thyroid

Loading next page...
 
/lp/american-medical-association/a-current-analysis-of-primary-lymphoma-of-the-thyroid-suqZBJzwi8
Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1991.01410340037006
Publisher site
See Article on Publisher Site

Abstract

Abstract • Over a 9-year period ending in May 1990, 27 patients with histologically proved thyroid lymphoma were assessed and treated. There were 24 female and three male patients with a median age of 67 years at the time of diagnosis (age range, 39 to 85 years). The usual presentation was that of a rapidly enlarging neck mass. Incisional biopsy was the diagnostic procedure of choice; however, nine of 27 patients underwent diagnostic partial or total thyroidectomy based on a preoperative impression of thyroid carcinoma. All 27 patients had non-Hodgkin's lymphomas of intermediate (77%) or high (23%) grade. Detailed staging was carried out in 25 patients; seven patients (28%) had disease confined to the thyroid gland (stage I), while 18 (73%) had accompanying disease in cervical lymph nodes or the mediastinum (stage II). Combined multiagent chemotherapy and irradiation was given to 19 of 25 staged patients (76%). Actuarial, overall 5-year survival for all patients was 70% with 48 months being the median follow-up for living patients (follow-up range, 3 to 102 months). Of a number of factors evaluated using log-rank survival tests, only the absence of dysphagia at the time of hospital admission, a primary tumor mass not greater than 10 cm, restriction of disease to the thyroid gland, and the absence of mediastinal lymph node involvement were statistically significant predictors of improved survival. Surgery should usually be restricted to diagnostic biopsy, as there is infrequently a role for resection in the management of thyroid lymphoma, given the effectiveness of combined multiagent chemotherapy and radiotherapy. (Arch Surg. 1991; 126:1199-1204) References 1. Staunton HD, Greening WP. Clinical diagnosis of thyroid cancer . BMJ . 1973;4:532-535.Crossref 2. Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas . Cancer . 1972;29:252-260.Crossref 3. Burke JS, Butler JJ, Faller LM. Malignant lymphoma of the thyroid: a clinical pathologic study of 35 patients including ultrastructural observations . Cancer . 1977;39:1587-1601.Crossref 4. Grimley RP, Oates GD. The natural history of malignant thyroid lymphomas . Br J Surg . 1980;67:475-477.Crossref 5. Souhami L, Simpson WJ, Carruthers JS. Malignant lymphoma of the thyroid gland . Int J Radiat Oncol Biol Phys . 1980;6:1143-1147.Crossref 6. Goudie R, Angouridakis CE. Autoimmune thyroiditis associated with malignant lymphoma of the thyroid . J Clin Pathol . 1970;23:377-381.Crossref 7. Hamburger JI, Miller JM, Kini SR. Lymphoma of the thyroid . Ann Intern Med . 1983;99:685-693.Crossref 8. Devine RM, Edis AJ, Banks PM. Primary lymphoma of the thyroid: a review of the Mayo Clinic experience through 1978 . World J Surg . 1981;5:33-38.Crossref 9. Aozasa K, Inoue A, Tajima K, Miyauchi A, Matsuzuka F, Kuma K. Malignant lymphomas of the thyroid gland: analysis of 79 patients with emphasis on histological prognostic factors . Cancer . 1986;58:100-104.Crossref 10. Meissner WA, Phillips MJ. Diffuse small cell carcinoma of the thyroid . Arch Pathol Lab Med . 1962;74:291-297. 11. Compagno J, Oertel JE. Malignant lymphoma and other lymphoproliferative disorders of the thyroid gland: a clinico-pathologic study of 245 cases . Am J Clin Pathol . 1980;74:1-11. 12. Rosen IB, Sutcliffe SB, Gospodarowicz MK, Chua T, Simpson WJ. The role of surgery in the management of thyroid lymphoma . Surgery . 1988;104:1095-1099. 13. Carbone PP, Kaplan HS, Musshoff K, Smither DW, Tubiana M. Report of the committee on Hodgkin's disease staging classification . Cancer Res . 1971;31:1860-1861. 14. Sirota DK, Segal RL. Primary lymphomas of the thyroid gland . JAMA . 1979;242:1743-1746.Crossref 15. Chak LY, Hoppe RT, Burke JS, Kaplan HS. Non-Hodgkin's lymphoma presenting as thyroid enlargement . Cancer . 1981; 48:2712-2716.Crossref 16. Esselstyn CB, Crile G. Evaluation of various types of needle biopsies of the thyroid . World J Surg . 1984;8:452-457.Crossref 17. Vigliotti A, Kong JS, Fuller LM, Velasquez WS. Thyroid lymphomas stages IE and IIE: comparative results for radiotherapy only, combination chemotherapy only, and multimodality treatment . Int J Radiat Oncol Biol Phys . 1986;12:1807-1812.Crossref 18. Tupchong L, Hughes F, Harmer CL. Primary lymphoma of the thyroid: clinical features, prognostic factors, and results of treatment . Int J Radiat Oncol Biol Phys . 1986;12:1813-1821.Crossref 19. Blair TJ, Evans RG, Buskirk SJ, Banks PM, Earle JD. Radiotherapeutic management of primary thyroid lymphoma . Int J Radiat Oncol Biol Phys . 1985;11:365-370.Crossref 20. Aozasa K, Inoue A, Yoshimuru H, et al. Intermediate lymphocytic lymphoma of the thyroid: an immunologic and immunohistologic study . Cancer . 1986;57:1762-1767.Crossref 21. Shimkin PM, Sagerman RH. Lymphoma of the thyroid gland . Radiology . 1969;92:812-816.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Oct 1, 1991

References