[A case of elderly Hashimoto disease presenting malignant lymphoma, gastric cancer and colon cancer].
An 87-year-old woman, who had been suffering from hypothyroidism and had been treated as an outpatient at our department since 1982, noticed left cervical swelling toward the end of November 1992. Because ultrasonic examination revealed a mass in her thyroid gland, she was admitted for a closer examination and additional treatment. Biopsy of thyroid gland revealed non-Hodgkin's lymphoma (NHL; the diffuse small cell type, B-cell origin). A part from the swelling of thyroid gland and the left cervical lymph node, performance of various examinations did not detected any other NHL lesions. Therefore, it was classified as stage II NHL according to the Ann Arbor classification. Laboratory data on admission were as follows; WBC 4,400/microliters, Hb 13.6 g/dl, platelet count 10.1 x 10(4)/microliters, GOT 51 IU/l, GPT 31 IU/l, TSH 1.17, free-T4 1.03, free-T3 2.04, and microsome test 1,600 x. Those data indicated marked hypothyroidism. In addition, stage IIa and IIc gastric cancers were detected by the examination with gastric endoscopy performed for stage classification. Both were adenocarcinomas. Because polyps were found in her sigmoid colon with colonoscopy, polypectomy was performed. The polyps were diagnose histologically as moderately differentiated adenocarcinoma. On July 20, COP-BLAM therapy was started (CPM 600 mg div, VCR 1.2 mg iv, ADR 30 mg iv on day 1, PDN 40 mg p.o and PCZ 100 mg p.o. on days 1-10, BLM 7.5 mg div on day 14). Subsequently, the left cervical lymph node swelling disappeared, and shrinkage of the mass in the thyroid gland was observed.(ABSTRACT TRUNCATED AT 250 WORDS)
Niitsu
N
N
First Department of Internal Medicine, Toho University School of Medicine.
Shikoshi
K
K
Takata
M
M
Umeda
M
M
D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications / Q000473:pathology*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000473:pathology*; D009378:Neoplasms, Multiple Primary / Q000150:complications; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000150:complications / Q000473:pathology*; D013967:Thyroiditis, Autoimmune / Q000150:complications*