A case of anaplastic diffuse large B-cell thyroid lymphoma: unique immunophenotype and unusual clinical presentation.

摘要

Primary thyroid lymphomas (TL) are rare representing only 1-5 of thyroid tumors (1). At present, the diagnosis of TL is often a challenge and the pre-operative cytological diagnosis is arduous, so that surgical histology is usually required for diagnosis (2).We describe the case of a primary anaplastic diffuse large B-cell lymphoma (DLBCL) of the thyroid.A 80-yr-old woman with a long lasting multinodular goiter presented a rapidly increasing respiratory distress, with symptoms of tracheal compression. The patient was eu-thyroid without thyroid auto-antibodies with a firm mass in the right thyroid lobe. The ultrasound imaging confirmed a dominant hypoechoic nodule in the right lobe. Standard X-ray imaging showed severe tracheal compression so that the patient was referred to the Surgery Department, where a total thyroidectomy was performed. At histological examination, surprisingly, the dominant nodule presented features consistent with the diagnosis of TL. Immunohistochemistry showed an unusual pattern of B-cell immunophenotype (CD20-; CD30+ CD79a+).