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Open Access Highly Accessed Case Report

Thyroid nodule as a first manifestation of Hodgkin lymphoma–report of two cases and literature review

Ewelina Szczepanek-Parulska1, Malgorzata Szkudlarek1, Przemyslaw Majewski2, Jan Breborowicz3 and Marek Ruchala1*

Author Affiliations

1 Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

2 Department of Clinical Pathology, Poznan University of Medical Sciences, Poznan, Poland

3 Department of Oncology, Poznan University of Medical Sciences, Poznan, Poland

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Diagnostic Pathology 2013, 8:116  doi:10.1186/1746-1596-8-116

Published: 15 July 2013

Abstract

Lymphomas account for less than 5% of thyroid malignant lesions. Vast majority of them are B-cell non-Hodgkin lymphomas (NHL), while Hodgkin lymphoma (HL) is extremely rare. Here we present two cases of HL, at baseline manifesting as a thyroid lesion. First patient, 29-year-old pregnant female, initially suspected for metastatic medullary thyroid cancer, was eventually diagnosed with mixed cellularity type of thyroid HL. Second patient, 22-year-old woman with suspicion of advanced thyroid cancer, was in the end diagnosed with an extra-lymphatic classical HL of the thyroid. In both cases, despite repeated fine-needle aspiration biopsy, cytological examination gave inconclusive or misleading results. On histopathological examination, thyroid tumor cells were positive for CD15 and CD30 antigen, which is typical for Reed-Sternberg cells. In the report authors also discuss difficulties in management as well as potential importance of novel methods such as FISH, PCR and other molecular techniques in diagnostics of thyroid lymphomas.

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2896947559559648 webcite

Keywords:
Thyroid nodule; Hodgkin lymphoma; Fine-needle aspiration biopsy (FNAB); Reed-Sternberg cells