Summary
Background. Our goal is to un cover crucial clinical and diagnostic aspects of primary thyroid lymphoma by analyzing scientific papers.
Material and methods. Search of scientific papers was done through Medline, UpToDate medical data bases and Google scholar search en gine. We used keywords: primary thyroid lymphoma, fine needle aspiration, Bethesda cytology, core needle biopsy. Publications from 2010 to 2020 were included.
Clinical case. In this case report we present a 28-year-old female who contacted her physician because of hoarseness, discomfort in the neck and neck swelling. She was consulted by an otorhino laryngologist and treated for suspected larynx infection with dexamethasone and cefazoline. The patient kept worsening and was sent for an endocrinologist consultation. Ultrasound examination was performed and a large thyroid nodule with malignant signs was found. Fine needle aspiration cytology was per formed, and atypia of undetermined significance was found. It was decided to perform diagnostic thyroid surgery be cause of rapid thyroid nodule enlargement. Final histologic examination determinates large B cells thyroid lymphoma. Imaging revealed multiple extralymphatic meta stases, primary IVA stage diffuses large B cells thyroid lymphoma. Patient received chemo therapy.
Conclusions. Primary thyroid lymphoma is a rare dis ease that is linked with auto immune and genetic risk factors. It is important to suspect this disease because the usual screening methods and fine needle aspiration cytology may often be insufficiently informative. In case of Bethesda III cytological category, it is recommended to perform diagnostic thyroid surgery or repeat fine needle aspiration cytology. If primary thyroid lymphoma is suspected core needle biopsy could be recommended to avoid surgery.
