Endocrine Abstracts

Background: Primary thyroid non Hodgkin’s lymphoma (PT-NHL), which defined as a lymphoma occurring in the thyroid gland with or without the involvement of regional lymph nodes, is a quite rare pathologic entity, accounting for 1,3-1,5 % of thyroid neoplasm, and 0,5% of lymphoma. there exists insufficient data to describe the incidence of mantle cell lymphoma in the thyroid gland. Due to this rarity and non specific clinical presentation, it seems essentiel to better understand the disease course. Thus we report this case in order tu study its clinical features and discuss management particularities.

Case presentation: A 58-year-old man, without pathological history, complaining from acute progressive dyspnea and dysphagia, associated with an enlarging anterior neck mass that increased rapidly through the last few weeks. On the clinical examination, we found a painless, hard huge goiter which depends mainly on the left lobe, fixed to the musculature, associated with bilateral lymph nodes. The laryngeal fibroscopy showed severe edema of the larynx, without modification of cordal mobility showed diffuse swelling of the thyroid compressing the airway tract. We proceed for diagnosing by a biopsy guided by the ultrasound imaging which confirms the mantle lymphoma of the thyroid; we complete the general evaluation by realizing a full body computed tomography in which we note the absence of other lymph node and a gastroscopy that eliminated the stomach localization. The disease was staging according to the classification proposed by Ann Arbor and modified by Myssof: stage IV. After 5 courses of chemotherapy R-CHOP, A complete remission was achieved. After a follow-up of 3 years, no relapse has occurred.

Conclusion: MCLs are usually diagnosed at an advanced stage, with mostly extranodal involvement, MCLs are classified as an aggressive lymphoma, with median survival of 3–5 years. Treatment options for MCL have been evolving. Chemotherapy and CHOP regimens have usually been used (cyclophosphamide, vincristine, doxorubicin, and prednisone). Immunotherapy (rituximab) and autologous stem cell transplantation have recently been used to treat patients.