原发于甲状腺的弥漫大B细胞淋巴瘤侵及上纵隔合并桥本甲状腺炎1例并文献复习

Diffuse large B-cell lymphoma of thyroid invading the superior mediastinum with hashimoto's thyroiditis:a case report and literature review

本文报道了吉林大学第一医院耳鼻咽喉头颈外科收治的1例累及上纵隔的原发于甲状腺的弥漫大B细胞淋巴瘤且合并桥本甲状腺炎患者,行右侧甲状腺腺叶切除术后转入肿瘤中心血液科接受R-CHOP方案化疗6个疗程,术后恢复良好,定期随访至12个月患者病情稳定,术区未见异常高代谢灶,考虑肿瘤活性抑制,浅表淋巴结、外周血细胞未见异常。该患者在诊断过程中遇到很多困难,先后就诊于国内2家三级甲等医院行穿刺后均未能确诊。原发于甲状腺的弥漫大B细胞淋巴瘤合并桥本甲状腺炎的患者不多,且侵及纵隔者尤为罕见,笔者在所查阅的资料中未见国内外相关报道。因此,本文将该病例进行报道,并回顾分析原发于甲状腺的淋巴瘤的病因、临床症状、诊断和治疗。

This article reports a case of primary thyroid diffuse large B-cell lymphoma involving the superior mediastinum with Hashimoto's thyroiditis admitted to the Department of Otolaryngology and Head and Neck Surgery,First Hospital of Jilin University.This patient underwent right thyroid lobectomy and was transferred to the Department of Hematology of the Oncology Center for 6 courses of chemotherapy with R-CHOP protocol.The postoperative recovery was good,and the patient was regularly followed up for 12 months after the operation.The patient's condition was stable,and CT showed no abnormally high metabolism in the operation area indicating the inhibition of tumor activity,superficial lymph nodes and peripheral blood cells were normal.The case encountered many difficulties in the diagnosis process,and the diagnosis was not confirmed after puncture in two Grade III Class A hospitals in China.There are few patients with primary thyroid diffuse large B-cell lymphoma complicated with Hashimoto's thyroiditis,and it is particularly rare to invade the mediastinum.There is no report in China and abroad in the literature we reviewed.Therefore,this article reports the case and retrospectively analyzes the etiology,clinical symptoms,diagnosis and treatment of primary thyroid lymphoma.