由原发性甲状腺 MALT 淋巴瘤转化而来的弥漫大 B 细胞淋巴瘤病例

Youngrok Jo, Youn Jin Cho, Ju Yeon Pyo, Hye Ran Lee
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摘要

弥漫大B细胞淋巴瘤(DLBCL)是原发性甲状腺淋巴瘤的主要亚型,在组织学上可由低级别B细胞淋巴瘤转变而来。这些特殊DLBCL的特征和治疗指南尚未完全确定。原发性甲状腺DLBCL的主要治疗方法是化疗和放疗等多模式治疗。一位57岁的女性患者因颈部前部肿块长期增大而到我院门诊就诊。影像学检查发现甲状腺肿块压迫气道和食道,经切除活检确诊为MALT淋巴瘤。分期后,患者接受了甲状腺全切除术和区域淋巴结清扫术,以治疗 IIE 期 MALT 淋巴瘤并缓解气道受损症状。最终诊断为由 MALT 淋巴瘤转化而来的 DLBCL,并进行了化疗。我们报告了这一罕见病例,并回顾了相关文献。
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A Case of Diffuse Large B-cell Lymphoma Transformed from Primary Thyroid MALT Lymphoma
Diffuse large B cell lymphoma (DLBCL) is main subtype of primary thyroid lymphoma and can be histologically transformed from a low-grade B-cell lymphoma. The characteristics and treatment guidelines of these particular DLBCL have not been fully established. The mainstay of treatment of primary thyroid DLBCL is multimodality treatment with chemotherapy and radiotherapy. Meanwhile, surgery can be considered only for diagnosis or alleviation of airway compressive symptoms.A 57-year-old female visited our outpatient clinic for recently enlarged long-held anterior neck mass. A thyroid mass compressing the airway and esophagus was identified on imaging, which was diagnosed as MALT lymphoma by excisional biopsy. After staging, the patient underwent total thyroidectomy with regional lymph node dissection for treatment of stage IIE MALT lymphoma and relieving airway compromise symptoms. The final diagnosis was DLBCL transformed from MALT Lymphoma, and chemotherapy was additionally performed. We report this rare experience with a review of literature.
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