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摘要


Background. Primary thyroid lymphoma accounts for less than 5% of thyroid malignancies and is more common in females. Patients present with a neck mass, and an open biopsy is usually necessary to confirm the diagnosis. However, the accuracy of fine-needle aspiration has improved the diagnostic ability due to improvements in immunohistochemistry analysis. Methods. We report a case of primary thyroid lymphoma in whom the diagnosis was confirmed by fine-needle aspiration. Results. A 55-year-old male presented with an enlarging neck mass. Laboratory data revealed normal thyroid function with positive TPO antibodies. A thyroid ultrasound showed hypoechoic and heterogenous goiter, and a fine-needle aspiration smear revealed predominantly mononuclear cells and histiocytes. After steroid treatment the size decreased, but then increased again after stopping the steroid treatment. Thus, fine-needle aspiration was performed again with immunohistochemistry analysis which was positive for CD20. The final diagnosis was diffuse large B cell lymphoma. Conclusion. Primary thyroid lymphoma is a rare thyroid malignancy, and patients present with a neck mass. An open biopsy is traditionally needed to confirm the diagnosis. Our case highlights that a fine-needle aspiration smear combined with immunohistochemistry analysis is useful for diagnosis.

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