Primary thyroid diffuse large B-cell lymphoma: a case report and focused review of the literature.
Kürsat Kirkgöz, Katja Weisel, Carsten Bokemeyer et al.
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Case in brief
A 74-year-old woman presented with dyspnoea, hoarseness, and cough and was diagnosed with primary thyroid non-GCB-type diffuse large B-cell lymphoma, stage IE (IPI 2). R-CHOP with CNS prophylaxis achieved complete remission. Six years later, lymphoma relapsed in the contralateral thyroid gland without reported disease elsewhere. Off-label Pola-R-miniCHP treatment led to a second complete remission.
What made this case unusual
The relapse was isolated to the opposite thyroid gland after a six-year remission, rather than being reported at another site.
Diagnostic / clinical pearl
Reliable histopathological characterization of suspected primary thyroid lymphoma may require core needle or surgical biopsy; the review notes that surgery was largely used for diagnosis.
Why it matters
The authors highlight the limited evidence-based guidance for primary thyroid DLBCL and the need for registry-based studies, particularly of primary extranodal DLBCL, to inform treatment guidelines.