Endocrine Abstracts

Introduction: Primary thyroid lymphomas are rare (2–5% of thyroid cancers and less than 5% of extra-ganglionic lymphomas). The most frequent types are B-cell lymphoma and MALT lymphoma. Posing a diagnosis problem, including differential diagnosis with anaplastic cancer. We report two different cases of thyroid lymphoma.

Observation: Case 1: Women 64-year-old, followed by 7 years for Hashimoto’s thyroid consulted for a cervical mass, of rapid evolution and compressive signs, cervical ultrasound: thyroid diving in the mediastinum exceeding 200cc and right lymph node, cervico-thoracic CT: tracheal stenosis with compression, bronchial or oesophageal breccia and mediastinitis. The biopsy found lymphoma diffused into large B cells. The patient dies quickly before initiating treatment.

Case 2: Man 78-year-old with no history, consults following the appearance of a cervical mass, cervical ultrasound: thyroid nodule eutirads 5, cervico-thoracic CT: large goitre diving into the thorax with mass syndrome on tracheoesophagea, the biopsy evokes an aggressive type B thyroid lymphoma. The patient had chemotherapy based CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) with good locoregional evolution.

Discussion: The risk of developing thyroid lymphoma is multiplied by 67 in case of lymphocytic thyroiditis. Because of their rarity and their clinical polymorphism, thyroid lymphomas have revealed diagnostic difficulties. Therapeutic conduct is currently well codified. Their prognosis, depending on the histology and stage of the disease, was favorable with a 5-year survival rate of 70 to 80%.

Conclusion: Due to the different therapeutic management, thyroid lymphoma is a diagnosis that must be mentioned in front of any cervical mass with rapid evolution, especially if there is a history of thyroiditis.