Halil COŞKUN, Alp BOZBORA, Yeşim ERBİL, Selçuk ÖZARMAĞAN, Yersu KAPRAN

Tiroit neoplazileri içinde primer tiroit lenfoma sıklığı

Amaç: Tirot malignitesi tanısı konan olgular içindeprimer tiroit lenfoma sıklığı araştırıldı.Hastalar ve Yöntemler: Ocak 1990 ile Aralık 2000 tarihleri arasında tirot malignitesi saptanan 304 olgunun geriye dönük incelemesinde dört olguda %1.3 primer tiroitlenfoması saptandı. Tümü kadın olan dört hastanın yaşortalaması 56.2 idi. Tüm hastalar fizikmuayene, tam biyokimya incelemesi, tiroit hormon düzeyleri T3, T4, TSH, tiroglobulin , tiroit sintigrafisi, tiroitince iğne aspirasyon biyopsisi ve boyun bilgisayarlı tomografisi BT ile değerlendirildi. Histopatolojik sonuçlarREAL Revised European-American Lymphoma sınıflandırmasına göre değerlendirildi.Bulgular: Hastalarda en yaygın şikayet boyunda büyüyen kitle, nefes darlığı ve horlamaydı. Tüm hastaların tiroit hormon seviyeleri normal, tiroglobulin düzeyleri ise normalden 5-10 kat yüksek bulundu. Ameliyat öncesi değerlendirmede iki hastada ince iğne aspirasyon biyopsisi sonuç vermezken boyun BT’si tanıda yardımcı oldu. Tüm hastalarda histopatolojik tanı B hücreli lenfoma idi. Ameliyat sonrasında üç hastaya kemoterapi, bir hastaya radyoterapi ve kemoterapi uygulandı. Hastaların tümü 1997 yılından önceameliyat edildi; bir hasta kaybedildi, üç hasta nüks olmaksızın izlenmektedir.Sonuç: Lokalize tiroit lenfomalı olgularımız dikkate alındığında, cerrahi tedavi ile birlikte kemoterapi ve/veyaradyoterapinin etkili olduğunu söyleyebiliriz

Anahtar Kelimeler:

Lenfoma/patoloji/cerrahi, tiroit neoplazisi/patoloji/cerrahi, tiroidektomi

The incidence of primary thyroid lymphoma in thyroid malignancies

Objectives: We investigated the incidence of primary thyroid lymphoma in thyroid malignancies.Patients and Methods: A total of 304 patients whose diagnoses were made as thyroid malignancies betvveen January 1990 and December 2000 were retrospectively evaluated. Of these, primary thyroid lymphoma was documented in four female patients 1.3%; mean age 56.2 years; range 40 to 65 years . Findings from history, physical examination, blood biochemistry, thyroid hor- mone levels Tg, T4, TSH, thyroglobulin , thyroid scintig- raphy, fine-needle aspiration biopsy, and cervical com- puted tomography CT were evaluated. Histopathologic results were evaluated according to the Revised European-American Lymphoma REAL classification.Results: The most common complaints on admission were a rapidly grovving cervical mass, hoarseness, and dyspnea. İn ali the cases, thyroid hormone levels were normal, but thyroglobulin levels were 5 to 10 times as high as normal. Preoperative fine-needle aspiration was not helpful in two cases, vvhereas cervical CT was diag- nostic. Pathologic diagnosis was diffuse large B celi lym phoma in ali the cases. Postoperatively, three cases undervvent chemotherapy and one case chemotherapy combined with radiotherapy. AH the patients were operated on before 1997; one patient died, the remaining three patients have been under follow-up with no recurrences.Conclusion: İn our cases, treatment of localized thyroid lymphoma by surgery combined with chemotherapy or/and radiotherapy was effective.

Keywords:

Lymphoma/pathology/surgery, thyroid neoplasms/ pathology/surgery, thyroidectomy,

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