title: [Clinical evaluation of 24 cases of primary thyroid malignant lymphoma].
abstract: OBJECTIVE
  We analyzed open biopsy in diagnosing primary thyroid lymphoma (PTL) and tumor management with compression symptoms and therapy.
  
  
  METHODS
  We retrospectively studied 24 subjects diagnosed with PTL from December 1997 to June 2010.
  
  
  RESULTS
  Open biopsy was done in 23 of 24 subjects. Incisional biopsy was done in 14, 13 of whom yielded sufficient materials in the first biopsy. Excisional biopsy was done in the remaining 9, 2 of whom developed permanent recurrent laryngeal nerve palsy after biopsy. The five with airway obstruction underwent incisional biopsy followed by immediate steroid administration of dexamethasone or methylprednisolone. All had histopathologically confirmed diagnosis and airway symptoms were resolved within a few days. Multidisciplinary therapy including chemotherapy, radiotherapy, and surgery was applied in 20 of 24 subjects. Single therapy was done in 4-chemotherapy in 2 and radiotherapy and surgery in 1 each. Overall results were satisfactory, with a 92% 10-year disease-free survival rate and an 86% 10-year overall survival rate based on the Kaplan-Meier method with 46-month median follow up.
  
  
  CONCLUSIONS
  When diagnosing PTL, especially large tumors spreading into extrathyroid tissue, incisional biopsy is more advantageous in histopathological diagnosis than excisional biopsy due to the lower risk of surgical complications. In a case involving a small intrathyroidal nodule, excisional biopsy is safer and more diagnostically accurate. In an airway obstruction emergency, once a definitive diagnosis is made, steroid administration plus endotracheal intubation, if necessary, for airway management is optimal management. Subjects with stage IE mucosa-associated lymphoid tissue (MALT) lymphomas can be treated with radiotherapy or surgery alone. Those with diffuse large B-cell lymphoma (DLBCL) or greater than stage IE MALT lymphoma, however, should be treated with multidisciplinary therapy because they have a potentially poor outcome.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kobe City Medical Center General Hospital, Kobe.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuchi
authors.forename: Shogo
authors.initials: S
authors.lastname: Shinohara
authors.forename: Keizo
authors.initials: K
authors.lastname: Fujiwara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamazaki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kanazawa
authors.forename: Risa
authors.initials: R
authors.lastname: Kurihara
authors.forename: Ippei
authors.initials: I
authors.lastname: Kishimoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Harada
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Naito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058109:Airway Management; D001706:Biopsy / Q000009:adverse effects* / Q000379:methods*; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology