Usefulness of core needle biopsy for the diagnosis of thyroid Burkitt's lymphoma: a case report and review of the literature

BMC Endocr Disord. 2018 Nov 19;18(1):86. doi: 10.1186/s12902-018-0312-9.

Abstract

Background: Thyroid lymphomas are an exceptional finding in patients with thyroid nodules. Burkitt's lymphoma is one of the rarest and most aggressive forms of thyroid lymphomas, and its prognosis depends on the earliness of medical treatment. Given the rarity of this disease, making a prompt diagnosis can be challenging. For instance, fine-needle aspiration (FNA) cytology, which is the first-line diagnostic test that is performed in patients with thyroid nodules, is often not diagnostic in cases of thyroid lymphomas, with subsequent delay of the start of therapy.

Case presentation: Here we report the case of a 52-year-old woman presenting with a rapidly enlarging thyroid mass. Thyroid ultrasonography demonstrated a solid hypoechoic nodule. FNA cytology was only suggestive of a lymphoproliferative disorder and did not provide a definitive diagnosis. It is core needle biopsy (CNB) that helped us to overcome the limitations of routine FNA cytology, showing the presence of thyroid Burkitt's lymphoma. Subsequent staging demonstrated bone marrow involvement. The early start of an intensive multi-agent chemotherapy resulted in complete disease remission. At 60 months after the diagnosis, the patient is alive and has not had any recurrence.

Conclusions: Clinicians should be aware that thyroid Burkitt's lymphoma is an aggressive disease that needs to be treated with multi-agent chemotherapy as soon as possible. To diagnose it promptly, they should consider to order/perform a CNB in any patient with a rapidly enlarging thyroid mass that is suspicious for lymphoma.

Keywords: Burkitt’s lymphoma; Case report; Core needle biopsy; Thyroid; Thyroid lymphomas.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Biopsy, Large-Core Needle / methods
  • Burkitt Lymphoma / diagnostic imaging
  • Burkitt Lymphoma / pathology*
  • Female
  • Humans
  • Middle Aged
  • Thyroid Gland / diagnostic imaging
  • Thyroid Gland / drug effects
  • Thyroid Gland / pathology*
  • Thyroid Neoplasms / diagnostic imaging
  • Thyroid Neoplasms / drug therapy
  • Thyroid Neoplasms / pathology*
  • Thyroid Nodule / diagnostic imaging
  • Thyroid Nodule / drug therapy