Primary thyroid lymphomas (PTL) are rare cancers, accounting for 1-5% of thyroid malignancies and 2% of all extranodal lymphomas. The relatively large experience reported from the Fudan University Shanghai Cancer Center in this issue of the Journal of Surgical Oncology is consistent with previously reported experience in the literature. Most PTL are non-Hodgkin lymphomas (NHL) of clonal B-cell origin. Primary Hodgkin lymphoma of the thyroid is exceedingly rare. Diffuse large B-cell lymphoma (DLBCL) is the most common histology, and less aggressive histologies, led by marginal zone lymphomas (or mucosa associated lymphoid tumors-MALT), are also seen. Association with Hashimoto's throiditis (HT) was noted in 63% of patients in the Shanghai series. In a recent report, three of 12 patients with both HT and PTL had clonal immune globulin heavy chain rearrangement in areas of HT with at least 96% homology to the clonal bands identified in the PTL, suggesting a possible evolution from HT to PTL [1].
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