Abstract
This paper presents a case of malignant lymphoma of the thyroid causing a dyspnea in a patient with schizophrenia. A 71-year-old male in a mental hospital developed a difficulty in breathing, and was referred to the hospital for a suspicion of thyroid cancer. Palpation of the neck revealed a large goiter and enlarged lymph node. He had a labored respiration and a stridor was audible. Malignant lymphoma of the thyroid was suspected, and the diagnosis was confirmed by an emergency aspiration biopsy cytology. The patient was admitted to the psychiatry ward. Immediately after the admission, a combination chemotherapy (CHOP) was started, followed by an incisional biopsy of the goiter. The tumors rapidly decreased in size, and the patient was relieved from the dyspnea. After two courses of CHOP regimen, a 41Gy of radiation therapy was given. The tumors showed a complete response to these therapies. He was given several courses of CHOP regimen in another mental hospital. At present there is no evidence of recurrence of the disease.
We emphasize the importance of rapid diagnosis and emergency chemotherapy in patients with thyroid malignant lymphoma causing a dyspnea.
