Department of Medicine, Division of Endocrinology and Metabolism; Department of Pathology; Department of Medicine, Division of Hematology and Oncology
Endocrine System Diseases | Endocrinology, Diabetes, and Metabolism | Hemic and Lymphatic Diseases | Neoplasms | Otorhinolaryngologic Diseases | Pathology
Background: While 2% of all extranodal Non-Hodgkin Lymphomas present in the thyroid, there exists insufficient data to describe the incidence of mantle cell lymphoma in the thyroid. A case series of 1400 patients revealed that < 1% of thyroid lymphomas may be MCL; hence better understanding of the disease course is essential.
Patient Findings: A 65-year-old female was referred for a multinodular goiter. Multiple fine needle aspirations from the dominant right nodule were consistent with Hashimoto's thyroiditis and flow cytometry was negative. Due to progressing dysphagia, she underwent total thyroidectomy.
Summary: Pathology revealed MCL with mantle zone growth pattern in the right thyroid. Flow cytometry showed monoclonal B cells comprising 9% of total cells. The Ki-67 index was 10%. She was diagnosed as having stage IIE MCL and offered conservative management by medical oncology, given that she had no B symptoms.
Conclusion: Though chemotherapy is the treatment of choice in MCL, a subset of patients with low-grade disease may be observed. As in our patient, mantle zone growth pattern and a Ki-67 index < 10% suggest a favorable prognosis. A diagnosis of primary MCL in the thyroid remains rare and staging modalities as well as treatment options continue to evolve.
mantle cell lymphoma, thyroid
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Copyright © 2017 Uzma Mohammad Siddiqui et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI of Published Version
Case Rep Pathol. 2017;2017:6749801. doi: 10.1155/2017/6749801. Epub 2017 Dec 25. Link to article on publisher's site
Case reports in pathology
Siddiqui UM, Rao SN, Galera PK, Islam N, Torres MS. (2017). Mantle Cell Lymphoma in the Thyroid: A Rare Presentation. Open Access Articles. https://doi.org/10.1155/2017/6749801. Retrieved from https://escholarship.umassmed.edu/oapubs/3330
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