Down syndrome with primary thyroid diffuse large B-cell lymphoma and Hashimoto thyroiditis: A CARE compliant case report.

Abstract:

RATIONALE:Adult patients with Down syndrome (DS) commonly develop Hashimoto thyroiditis (HT). However, primary diffuse large B-cell lymphoma (DLBCL) of the thyroid is uncommon, and its simultaneous occurrence with HT is very rare. To our knowledge, coexisting DLBCL and HT in a patient with DS has not been reported in the medical literature. PATIENT CONCERNS:We present a 43-year-old woman with DS who reported progressive swelling of the neck on the right side and dyspnea over the previous 1 month, with associated neck ache, hoarseness, and dysphagia. Thyroid ultrasonography and computed tomography of the neck revealed a large mass in the right lobe compressing the surrounding tissues. DIAGNOSES:Based on the clinical and histopathologic findings, the patient was diagnosed with coexisting primary thyroid DLBCL and HT. INTERVENTIONS:A palliative unilateral thyroidectomy was performed; postoperative histopathology and immunohistochemistry revealed thyroid DLBCL and HT. The patient was scheduled for chemotherapy and targeted therapy after recovering from surgery. OUTCOMES:The patient died 3 weeks after surgery due to asphyxia caused by uncontrollable growth of recurrent tumor. LESSONS:The coexistence of DS, primary thyroid DLBCL, and HT is very rare. There is no standardized approach to the clinical identification of primary thyroid lymphoma (PTL), making early diagnosis difficult. A multidisciplinary approach and close follow-up are needed. The mechanisms of the link between DS and PTL are poorly understood and remain to be elucidated.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Wei L,Zhao N,Li Y,Zheng X,Zhang H,Zhang Z

doi

10.1097/MD.0000000000016994

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

e16994

issue

35

eissn

0025-7974

issn

1536-5964

pii

00005792-201908300-00062

journal_volume

98

pub_type

杂志文章

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