DOI: 10.36347/sasjm.2023.v09i10.010

Pages: 1087-1091

Primary thyroid lymphoma (PTL) is an exceptionally rare malignant tumor originating in the thyroid gland, comprising just 5% of thyroid malignancies and 2% of extranodal lymphomas. Its clinical presentation is unspecific, and diagnosis relies on histological examination. We describe a case of a 70-year-old woman with a swiftly enlarging anterior neck swelling causing dyspnea and dysphagia over six months, alongside weight loss and anorexia. Clinical examination unveiled a painless, constricting goiter with cervical adenopathy. Ultrasonography revealed a multi-heteronodular goiter with a suspicious left loboishmic nodule. CT and 18 FDG PET-CT scans indicated an intensely hypermetabolic cervical tumor infiltrating the thyroid and extending into the thoracic region with lymph node and bone involvement, suggesting high-grade lymphoma. The patient underwent total thyroidectomy and lymph node dissection, followed by favorable outcomes after polychemotherapy. PTL is an uncommon cause of thyroid malignancy and extranodal lymphomas. It should be suspected in patients presenting with a growing neck mass, particularly in those with a history of Hashimoto's thyroiditis. Although certain ultrasound features may suggest PTL, a biopsy remains the definitive diagnostic tool. The most prevalent PTL subtype is diffuse large B-cell lymphoma (DLBCL), constituting over 50% of cases. Treatment and outcomes hinge on both stage and histological subtype. Radiation and chemotherapy are the primary treatments, given PTL's sensitivity to these modalities. Localized, less aggressive lymphomas can be treated with radiation alone, while disseminated or aggressive subtypes may require combined modality treatment (CMT). Surgery is an option when patients experience compressive symptoms or airway obstruction. Prognosis varies depending on factors like stage and histological subtype, underscoring the need for personalized management. In summary, PTL necessitates a multidisciplinary approach for .....