T-cell lymphoma in Hashimoto's thyroiditis.
An elderly Caucasian woman with a 2-year-history of hypothyroidism, treated with thyroxine, presented with a rapidly growing mass in the thyroid. The morphological and immunological features of this thyroid tumour were those of a peripheral T-cell lymphoma with an immunophenotype commonly associated with HTLV-1 positive-adult T-cell leukaemia/lymphoma, although serology for HTLV1 antibody was negative. Monoclonal gene rearrangements were demonstrated with T-cell receptor beta- and gamma-specific primers. There are several interesting features in this case (i): although primary B-cell lymphomas (MALT-associated lymphomas) of thyroid are a well-recognized sequel to thyroiditis, primary T-cell lymphomas are rare, even in areas of the world where adult T-cell lymphomas predominate; (ii) the tumour showed the typical immunophenotype of an HTLV-1 positive T-cell lymphoma but the patient is English, has not visited endemic areas, and is serologically negative for HTLV-1; (iii) the residual thyroid gland showed a florid lymphocytic thyroiditis with Hürthle cell change, typical of Hashimoto's thyroiditis; (iv) unlike other reports of thyroid T-cell lymphoma, which have presented with stage III-IV disease, this tumour presented in the favourable clinical stage of IE.
Abdul-Rahman
Z H
ZH
Department of Histopathology, St George's Hospital, London, UK.
Gogas
H J
HJ
Tooze
J A
JA
Anderson
B
B
Mansi
J
J
Sacks
N P
NP
Finlayson
C J
CJ
D015415:Biomarkers / Q000032:analysis; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D015329:Gene Rearrangement, T-Lymphocyte; D006801:Humans; D007124:Immunoenzyme Techniques; D016130:Immunophenotyping; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D016399:Lymphoma, T-Cell / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D013967:Thyroiditis, Autoimmune / Q000235:genetics / Q000276:immunology / Q000473:pathology*
D015415:Biomarkers