Primary thyroid lymphoma: A multi-center retrospective review.

BACKGROUND: Primary thyroid lymphoma (PTL) is rare and diagnosis is challenging.

METHODS: We conducted a multicenter retrospective study of patients with PTL from 1990 to 2023 to determine method of diagnosis, treatment, and outcomes.

RESULTS: The study cohort included 31 patients with PTL; all had thyroid enlargement; 21 (68 ​%) had compressive symptoms, 11 (35 ​%) had hypothyroidism and 3 had (10 ​%) B symptoms. Diagnosis was established from incisional biopsy in 8 (26 ​%), needle biopsy in 4 (13 ​%), excisional lymph node biopsy in 1 (3 ​%), and thyroidectomy specimens in 18 (58 ​%). 15 (48 ​%) patients had Hashimoto thyroiditis. Treatment included chemotherapy in 19 (61 ​%); surgery alone in 7 (23 ​%); and radiation alone or with surgery in 5 (16 ​%) patients. One (3 ​%) patient recurred, and 4 (13 ​%) patients died after a median 4.2 years.

CONCLUSION: Diagnosis of PTL was made in only 13 ​% of patients preoperatively. There may be opportunity for needle biopsy to facilitate earlier diagnosis and treatment.