Document Detail


Burkitt-like lymphoma infiltrating a hyperfunctioning thyroid adenoma and presenting as a hot nodule.
MedLine Citation:
PMID:  20825299     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Most solitary hyperfunctiong regions on thyroid scan consist of benign tissue. Here we report a patient with a Burkitt-like lymphoma that was infilterated into a region containing a hyperfunctioning nodule.
SUMMARY: A 56-year-old man was referred to our Endocrine Unit in May 2009 due to the incidental discovery of a large left thyroid lobe nodule by a computed tomography study. This had been performed to search for a primitive tumor in a patient with bone metastasis. He was clinically and biochemically thyrotoxic with no evidence of humoral thyroid autoimmunity. The nodule had a dyshomogenous appearance at neck ultrasonography, with multiple hypoechogenic areas and calcifications. (99m)-Technetium thyroid scintiscan revealed a hot nodule with suppression of the contralateral lobe. Fine-needle aspiration cytology indicated the presence of neoplastic cells not of thyroid origin. Remission of hyperthyroidism was obtained with methimazole, and the patient was submitted to left lobe thyroidectomy and istmectomy. Histological analysis of the surgical specimen led to a diagnosis of Burkitt-like large B-cell lymphoma harbored within a thyroid adenoma. After further staging, the final diagnosis was stage IV E Burkitt-like lymphoma with the involvement of the bone and the thyroid. This is the first description of an aggressive Burkitt-like lymphoma that infiltrated an hyperfunctioning thyroid adenoma, thus presenting as a hot nodule at thyroid scintiscan. In our patient there was no humoral or histological evidence of thyroid autoimmunity, thus suggesting a metastatic seeding of the lymphoma within the hyperfunctioning thyroid nodule.
CONCLUSIONS: Involvement of the thyroid gland by Burkitt-like lymphoma is extremely rare as is close localization of malignancy and a hyperfunctioning thyroid nodule. As highlighted by the present report, performing fine-needle aspiration cytology should be always considered in the clinical context of a metastatic disease of unknown origin or when there are ultrasonography signs suggesting malignancy, even when the nodule is hyperfunctioning.
Authors:
Antonella Camera; Flavia Magri; Rodolfo Fonte; Laura Villani; Matteo G Della Porta; Vittorio Fregoni; Luigi La Manna; Luca Chiovato
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  20     ISSN:  1557-9077     ISO Abbreviation:  Thyroid     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-09     Completed Date:  2011-01-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1033-6     Citation Subset:  IM    
Affiliation:
Fondazione Salvatore Maugeri IRCCS, University of Pavia, Pavia, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adenoma / diagnosis*,  drug therapy,  surgery
Antineoplastic Agents / therapeutic use
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Biopsy, Fine-Needle
Bone Neoplasms / secondary
Burkitt Lymphoma / diagnosis*,  drug therapy,  surgery
Cyclophosphamide / therapeutic use
Dexamethasone / therapeutic use
Doxorubicin / therapeutic use
Humans
Hyperthyroidism / drug therapy,  surgery
Male
Methimazole / therapeutic use
Middle Aged
Neoplasm Staging
Technetium / diagnostic use
Thyroid Neoplasms / diagnosis*,  drug therapy,  surgery
Thyroid Nodule / diagnosis*,  drug therapy,  surgery
Vincristine / therapeutic use
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 23214-92-8/Doxorubicin; 50-02-2/Dexamethasone; 50-18-0/Cyclophosphamide; 57-22-7/Vincristine; 60-56-0/Methimazole; 7440-26-8/Technetium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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