Endocrine Abstracts

Thyroid lymphoma accounts for <5% of thyroid malignancies. Although it predominantly arises on a background of autoimmune thyroid disease (Hashimoto's thyroiditis), the mode of presentation, diagnosis and outcome are not well characterised.

We retrospectively analysed 25 patients presenting with thyroid lymphoma between 1996-2002. Patients were predominantly female (84%) with a mean age of 65yrs and presented with a rapidly growing goitre. A previous history of Hashimoto's thyroiditis was noted in 13 patients, all of whom were on thyroxine. The majority of cases (82%) were diagnosed by fine needle aspiration, open biopsy being required for the rest. Three lymphoma sub-types were identified: 16 (64%) had diffuse large B-cell lymphoma, 5(20%) follicular lymphoma and 5 (20%) mucosa-associated lymphoid tissue (MALT) lymphoma. The disease was localised in 18 (72%) and disseminated in 7 (28%) of patients. The majority of patients (71%) had surgery and chemotherapy whilst 28% had radiotherapy. 36% (8) patients died, all of whom presented with disseminated disease, whilst there was 100% survival when total thyroidectomy was performed for localised disease.

In conclusion, we demonstrate the heterogeneous presentation of thyroid lymphoma, the close relationship with Hashimoto's thyroiditis and response to various treatment modalities.