title: Reactive lymphoid hyperplasia of the thyroid followed by systemic autoimmune diseases: a case report.
abstract: BACKGROUND
  Reactive lymphoid hyperplasia is a benign nodular lesion characterized by marked proliferation of non-neoplastic, polyclonal lymphocytes forming follicles. The lesion is found in various organs such as skin, orbit, lung, gastrointestinal tract, and liver. However, reactive lymphoid hyperplasia in the thyroid gland is extremely rare. Here, we present an interesting case of reactive lymphoid hyperplasia in the thyroid, which suggests the nature of the disease.
  
  
  METHODS
  A 74-year-old Japanese man was referred to our institute because of a growing well-demarcated irregular-shaped mass in the right lobe of the thyroid. Malignant lymphoma was suspected by cytology, and right lobectomy was conducted. A final diagnosis of reactive lymphoid hyperplasia was made by the intimate investigation of the surgical specimen, with evidence of polyclonal and non-neoplastic lymphatic proliferations forming follicles with an active germinal center. After an initial uneventful postoperative course, our patient developed severe symptoms of systemic rheumatic arthritis, and alterations in autoimmune reaction, including clinically overt chronic thyroiditis, were identified.
  
  
  CONCLUSIONS
  Our case demonstrated important clinical information on reactive lymphoid hyperplasia of the thyroid, and suggested the importance of differential diagnosis, and possible close correlation between systemic autoimmune disorder and the disease.
authors.affiliation: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3, Ashahi-machi, Abeno-ku, Osaka 545-8585, Japan. nonoda@med.osaka-cu.ac.jp.
authors.forename: Naoyoshi
authors.initials: N
authors.lastname: Onoda
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ohsawa
authors.forename: Hidemi
authors.initials: H
authors.lastname: Kawajiri
authors.forename: Satoru
authors.initials: S
authors.lastname: Noda
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Kashiwagi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takashima
authors.forename: Kosei
authors.initials: K
authors.lastname: Hirakawa
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D006801:Humans; D008297:Male; D019310:Pseudolymphoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D013959:Thyroid Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D013967:Thyroiditis, Autoimmune / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D015415:Biomarkers