2015 Volume 63 Issue 4 Pages 225-231
A 75-year-old woman with Hashimoto's disease diagnosed 11 years previously was found to have a nodule in the anterior cervix. Ultrasonography showed a low echoic mass 5×4×3cm in diameter in the left lobe of the thyroid gland. Aspiration biopsy cytology (ABC) of the tumor indicated the possibility of lymphoma. Surgical resection of the left lobe of the thyroid gland was performed in order to obtain histopathological diagnosis. The thyroid tumor was diagnosed as a diffuse large B-cell lymphoma (DLBCL) with follicular lymphoma. Whole body CT and 67Ga-scintigraphy showed no abnormal findings in other organs, and the tumor stage was IE. After surgery, three courses of R-CHOP immunochemotherapy followed by radiotherapy to the neck were performed. There has been no sign of tumor recurrence in the 19 months since the operation. As seen in the present case, lymphoma should be considered in the differential diagnosis when a growing nodule appears in the anterior cervix in middle-aged and elderly women with Hashimoto's disease. Although, in the present case, the DLBCL was smaller than the follicular lymphoma within the tumor, the presence of DLBCL is important for the treatment of thyroid lymphoma. Because it is difficult to diagnose thyroid lymphoma precisely using ABC, surgery also plays an important role in obtaining a histopathologic diagnosis for multidisciplinary treatment.
