This case report describes a rare case of a 25-year-old male patient diagnosed with T-cell Non-Hodgkin's lymphoma originating in the thyroid gland. He presented with a large goiter that had been progressively enlarging over four months. Biopsy of the thyroid found lymphoid cells consistent with autoimmune thyroiditis initially, but further histopathological and immunohistochemistry examinations confirmed T-cell Non-Hodgkin's lymphoma. The patient received chemotherapy following debulking surgery and was being monitored six months later.

1. 18 th Annual Conference of
The Indian Association of Endocrine Surgeons
(IAESCON 2017)
Non-Hodgkin’s Lymphoma is divided into 2
main categories; namely B-cell (B-
lymphocyte) and T-cell (T-lymphocyte).
Out of these 2 types T-cell lymphocyte is
less common and presents only in 20% cases
of NHL.
Non-Hodgkin’s Lymphoma may appear in
the lymph nodes, sinuses, skin, bones, lungs,
liver and soft tissues.
But NHL affecting primarily to thyroid gland
is very rare.
Diagnosis may be difficult due to absence of
typical clinical / biological signs. But,
histopathological study confirms the
diagnosis and helps to determine the grades
of malignancy.
Dr. Priyadarshan Konar, Dr. Suman Sourav Rout, Prof. (Dr.) Prakash Kumar Sahoo
1. IMS & SUM Hospital, BBSR
2. IMS & SUM Hospital, BBSR
3. IMS & SUM Hospital, BBSR
T-CELL NON-HODGKIN’S LYMPHOMA
IN A CASE OF GOITER Your Logos
here
Contact Information: Dr. Priyadarshan Konar, PGT, Department of Surgery, IMS & SUM Hospital, BBSR. Ph. +91 9831561159, Email. dr.pkonar@gmail.com
There were no signs of local inflammation, swelling was moving with deglutition.
There was recent onset of hoarseness of voice.
Bilateral carotid pulses well felt, no palpable lymphadenopathy.
Swelling was extending into the retrosternal region.
Per abdomen examination reveals no organomegaly.
INVESTIGATION
Chest X-ray showed retrosternal extension.
TSH was within normal limits.
USG - enlarged both lobes of thyroid and isthmus showing
multiple ill defined mixed echogenic SOL within and minimal
vascularity with retrosternal extension.
Fine Needle Aspiration Cytology revealed lymphoid cells
impinging on follicular cells with Hurtle cell changes and lymphoid
cells in various stages of maturation; diagnosed as Autoimmune
Thyroiditis.
TREATMENT
Total thyroidectomy was planned, but only
debulking could be done due to gross adhesion
to the trachea and surrounding structures and
retrosternal extension.
The histopathological examination revealed
Non-Hodgkin’s lymphoma.
Subsequently, immunohistochemistry report
confirms the diagnosis as high-grade T-cell Non-
Hodgkin’s Lymphoma favoring peripheral T-cell
Lymphoma.
 Afterwards, L-Thyroxin
substitution therapy and
chemotherapy started. (CHOP
regimen 21 days interval x 6
cycles)
• 6 months after chemotherapy
REFERENCES
 Prof. (Dr.) Prakash Kumar Sahoo
 Department of Surgery, IMS & SUM Hospital, BBSR
 Department of Pathology, IMS & SUM Hospital, BBSR
1) Mahfoudhi, M., Khammassi, K., Gorsane, I., El Euch, M.,
Turki, S., Salah, M.B. and Abdallah, T.B. (2015) Primary
Thyroid Non-Hodgkin’s Lymphoma. Open Journal of
Pathology, 5, 114-116.
2) Khadilkar UN, Mathai AM, Chakrapani M, Prasad K. Rare
association of papillary carcinoma of thyroid with adult T-
cell lymphoma/leukemia. Indian J Pathol Microbiol
2010;53:125-7
3) Dündar HZ, Sarkut P, Kırdak T, Korun N. Primary thyroid
lymphoma. Turkish Journal of Surgery/Ulusal cerrahi
dergisi. 2016;32(1):75-77. doi:10.5152/UCD.2015.2935.
 Patient with T- Cell Non Hodgkin’s lymphoma
should be managed with chemotherapy after
surgery.
ON EXAMINATION
CASE REPORT
AIM
DISCUSSIONSIntroduction
CONCLUSIONs
Acknowledgements
 Presenting here a case of T- Cell Non
Hodgkin’s lymphoma in a case of goiter.
 This case is being presented because of
it’s rarity.
Malignant Lymphoma of the thyroid are
very uncommon.
Incidence is less than 2% of all thyroid
malignancies.
T-cell lymphomas are extremely rare and
accounts for less than 1%
We have come across a rare case of T-
Cell Non-Hodgkin’s Lymphoma
25-year-old male patient.
Presented with progressive swelling over
the anterior aspect of neck since 4
months.
Swelling size was approx. 10cm x 10cm,
extending laterally beyond
sternocleidomastoid muscle on each side.
There were no signs of local
inflammation, swelling was moving with
deglutition.
There was recent onset of hoarseness of
voice.
He had no history of fever or sweating or
rapid weight loss in the recent past.