Thyroid nodule as a first manifestation of Hodgkin lymphoma-report of two cases and literature review

Diagn Pathol. 2013 Jul 15:8:116. doi: 10.1186/1746-1596-8-116.

Abstract

Lymphomas account for less than 5% of thyroid malignant lesions. Vast majority of them are B-cell non-Hodgkin lymphomas (NHL), while Hodgkin lymphoma (HL) is extremely rare. Here we present two cases of HL, at baseline manifesting as a thyroid lesion. First patient, 29-year-old pregnant female, initially suspected for metastatic medullary thyroid cancer, was eventually diagnosed with mixed cellularity type of thyroid HL. Second patient, 22-year-old woman with suspicion of advanced thyroid cancer, was in the end diagnosed with an extra-lymphatic classical HL of the thyroid. In both cases, despite repeated fine-needle aspiration biopsy, cytological examination gave inconclusive or misleading results. On histopathological examination, thyroid tumor cells were positive for CD15 and CD30 antigen, which is typical for Reed-Sternberg cells. In the report authors also discuss difficulties in management as well as potential importance of novel methods such as FISH, PCR and other molecular techniques in diagnostics of thyroid lymphomas.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2896947559559648.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Biomarkers, Tumor / analysis
  • Biopsy, Fine-Needle
  • Diagnosis, Differential
  • Female
  • Fucosyltransferases / analysis
  • Hodgkin Disease / genetics
  • Hodgkin Disease / immunology
  • Hodgkin Disease / pathology*
  • Hodgkin Disease / therapy
  • Humans
  • Immunohistochemistry
  • Ki-1 Antigen / analysis
  • Lewis X Antigen / analysis
  • Molecular Diagnostic Techniques
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Complications, Neoplastic / genetics
  • Pregnancy Complications, Neoplastic / immunology
  • Pregnancy Complications, Neoplastic / pathology*
  • Pregnancy Complications, Neoplastic / therapy
  • Reed-Sternberg Cells / immunology
  • Reed-Sternberg Cells / pathology
  • Thyroid Nodule / genetics
  • Thyroid Nodule / immunology
  • Thyroid Nodule / pathology*
  • Thyroid Nodule / therapy
  • Treatment Outcome
  • Young Adult

Substances

  • Biomarkers, Tumor
  • Ki-1 Antigen
  • Lewis X Antigen
  • FUT4 protein, human
  • Fucosyltransferases