Abstract
Primary Thyroid lymphoma is an uncommon malignancy, which can rarely cause severe dyspnea. Its commonly difficultly diagnosed and rapid diagnosis and management may be lifesaving. Here we report a case presented with sudden thyroid growth and severe dyspnea, who was diagnosed as primary thyroid lymphoma. A 70-year-old woman applied with fatigue, rapidly enlarged goitre and severe progressive dyspnea. She had severe hypoxemia with an artery oxygen saturation of 59.2% and arterial PO2 of 33.9 mmHg. The ultrasound of the neck showed an enlarged thyroid gland with a mass in the left lobe. After admission to the hospital her dyspnea worsened and oxygen and bronchodilator treatment gave no benefit. IV methylprednisolone was administered, and the patient’s symptoms partially improved. Meanwhile in spite of supportive therapy, the patient underwent urgent surgery for acute airway obstruction and thyroidectomy was performed. After surgery the diagnosis was high grade diffuse large B-cell non-Hodgkin’s lymphoma.
Highlights
Thyroid nodules are common features and may be present in as much as 65% of the population (1), with a slow growth pattern even if they are malign nodules (2)
We present a patient with severe progressive dyspnea and hypoxia, who benefited from methylprednisolone at short-term period and was treated with surgery and chemotherapy
Dyspnea is seen in 55-65% of patient with primary thyroid lymphoma (7, 8), but presenting to the emergency department with progressive respiratory distress due to thyroid lymphoma is rare (4)
Summary
Progressive severe dyspnea and hypoxia due to primary thyroid lymphoma: steroid administration may be lifesaving. Derya Köseoğlu[1], Alper Çağrı Karcı[1], Aydın Acar[2], Elvan Evrim Tuna[2], Dilek Berker[1]
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