Co-Existence of Papillary Thyroid Carcinoma and B Cell Lymphoma in Hashimoto’s Thyroiditis. Our Approach from the Diagnosis to the Treatment. Case Report

Abstract

Introduction

Primary thyroid lymphoma (PTL) is a rare tumor accounting only about 1% to 5% of thyroid malignant tumors or 2 cases per million [1-3]. PTL is more frequent in women than men, with the ratio of occurrence ranging from 2:1 to 8:1 and is strongly associated with Hashimoto’s thyroiditis [4-6].

Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, and its incidence has been increasing in the last few decades, with a large prevalence of small tumors PTC in patients affected by Hashimoto’s thyroiditis (HT) is a well-known event reported by literature [7,8]. PTC occurs mainly in women, accounts approximately 70% to 80% of all thyroid carcinomas and has an excellent prognosis [9].

The co-existence of PTC and PTL in the same patient is rare, and the present case report aims to describe the co-existence of PTC with B-Cell Lymphoma in a background of Hashimoto’s thyroiditis. Treatment and follow-up issues are also addressed.

Case Report

Here, we describe the case of a 75-year-old woman, with no family history of thyroid cancer, she referred recent painless enlargement in the left anterior side of the neck, complaining of mild and intermittent dysphagia to solid foods, she denied any voice change or dyspnea, while physical examination demonstrated an enlarged thyroid gland with a palpable, firm nodular lesion in the left lobe, moving with deglutition. She did not complain before, for thyroid disease.

Thyroid ultrasonography (US) demonstrated the growth of a hypoechogene nodule in the left lobe, measuring 38x33 mm.