Endocrine Abstracts

Introduction: Primary thyroid non-Hodgkin’s lymphoma (PT-NHL), is a quite rare entity, accounting for 1.3–1.5% of thyroid neoplasm, and 0.5% of lymphoma. The extranodal marginal zone B-cell lymphoma of MALT, occurs in 23% of PTL. The aim of our work is to evaluate the clinicopathological features and treatment outcomes of patients with MALT primary thyroid lymphoma. We report two cases of MALT PTL taken care of in our department.

Observation 1: It was 56 years old man, with a history of hypothyroidism. Hospitalized in our department for management of an anterior basicervical swelling evolving for 4 years and rapidly increased associated with a recent deterioration in general condition as well as significant unquantified weight loss and intermittent dyspnea. The physical examination found a hard anterior basic cervical tumefaction, making 5 cm of MA associated with right jugular carotid adenopathy. Cervical ultrasound showed a multinodular goiter. Thyroid fine needle aspiration revealed a cluster of inflammatory cells with plasma cells without signs of malignancy. A lymph node biopsy found malignant cells in small clumps. The patient had a total thyroidectomy. The extemporaneous examination concluded a benign isthmic nodule. The definitive anatomopathological examination showed an aspect of low-grade MALT lymphoma rich in plasma cells. The patient was referred to hematology for additional treatment (chemotherapy). There was no relapse after 4 years of follow-up.

Observation 2: It was, 52 years old woman, with a medical history of adenocarcinoma of the colon in 2011 and neoplasia of the right breast in 2020, both treated by surgery and chemotherapy, who referred to our service for an anterior basicervical swelling evolving for 6 months rapidly increasing in size. The physical examination found a hard anterior basic cervical tumefaction, making 3 cm of MA associated with bilateral jugular carotid adenopathy. Cervical ultrasound showed a multinodular goiter. The patient had a total thyroidectomy. The extemporaneous examination concluded a benign nodule. The definitive anatomopathological examination showed an aspect of low-grade MALT lymphoma rich in plasma cells. The patient had a pet scan which was without abnormalities. Bone marrow biopsy showed non-infiltrated marrow. The hematologists decides then to monitor the patient and not administer chemotherapy because of the different arguments related to the patient and her tumor. There was no relapse after one year of follow-up.

Conclusion: Thyroid (MALT) is 23% of all thyroid lymphomas. The overall survival is estimated to be more than 90%. Its care is multidisciplinary.