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Abstract
Lymphomas account for less than 5% of thyroid malignant lesions. Vast majority of them are B-cell non-Hodgkin lymphomas (NHL), while Hodgkin lymphoma (HL) is extremely rare. Here we present two cases of HL, at baseline manifesting as a thyroid lesion. First patient, 29-year-old pregnant female, initially suspected for metastatic medullary thyroid cancer, was eventually diagnosed with mixed cellularity type of thyroid HL. Second patient, 22-year-old woman with suspicion of advanced thyroid cancer, was in the end diagnosed with an extra-lymphatic classical HL of the thyroid. In both cases, despite repeated fine-needle aspiration biopsy, cytological examination gave inconclusive or misleading results. On histopathological examination, thyroid tumor cells were positive for CD15 and CD30 antigen, which is typical for Reed-Sternberg cells. In the report authors also discuss difficulties in management as well as potential importance of novel methods such as FISH, PCR and other molecular techniques in diagnostics of thyroid lymphomas.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2896947559559648
Highlights
Hodgkin lymphomas (HL) is a biologically heterogeneous group of neoplasms
Lymphomas account for less than 5% of malignant lesions diagnosed in the thyroid identified in about two cases per million [6,7]
In our paper we aim to focus on subjects, in whom the diagnosis of HL was made in the course of evaluation of a thyroid lesion and later on involvement of other sites was detected
Summary
Hodgkin lymphomas (HL) is a biologically heterogeneous group of neoplasms. The incidence of HL in European Union is estimated at about 2.2-2.7/100 000 cases per year, constituting 11.7% of all lymphomas diagnosed in 2006 [1]. The majority of cases is in low-stage disease and presents the nodular sclerosis subtype. An increase in incidence of extra-nodal lymphomas has been observed over the past two decades [2]. Extra-nodal origin is more common in NHL and may reach 33% [3]. HL mainly arises in lymph nodes of the neck and mediastinum, while only approximately 5% develop in extra-nodal sites, including tonsils, nasopharynx, parotid glands, thyroid, parathyroid or nasal antrum, with or without concomitant nodal involvement [4]
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