Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Pathology
Volume 2017 (2017), Article ID 6749801, 6 pages
https://doi.org/10.1155/2017/6749801
Case Report

Mantle Cell Lymphoma in the Thyroid: A Rare Presentation

1Division of Endocrinology, University of Massachusetts Medical School, 55 Lake Avenue N., Worcester, MA 01655, USA
2Section of Endocrinology, MedStar Washington Hospital Center, 110 Irving St NW, Suite 2A-72, Washington, DC 20010, USA
3Department of Pathology, University of Massachusetts Medical School, Biotech 3, 1 Innovation Drive, Worcester, MA, USA
4Division of Hematology and Oncology, University of Massachusetts Medical School, 55 Lake Avenue N., Worcester, MA 01655, USA

Correspondence should be addressed to Uzma Mohammad Siddiqui; gro.lairomemssamu@iuqiddis.amzu

Received 4 August 2017; Revised 7 November 2017; Accepted 4 December 2017; Published 25 December 2017

Academic Editor: Piero Tosi

Copyright © 2017 Uzma Mohammad Siddiqui et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. While 2% of all extranodal Non-Hodgkin Lymphomas present in the thyroid, there exists insufficient data to describe the incidence of mantle cell lymphoma in the thyroid. A case series of 1400 patients revealed that <1% of thyroid lymphomas may be MCL; hence better understanding of the disease course is essential. Patient Findings. A 65-year-old female was referred for a multinodular goiter. Multiple fine needle aspirations from the dominant right nodule were consistent with Hashimoto’s thyroiditis and flow cytometry was negative. Due to progressing dysphagia, she underwent total thyroidectomy. Summary. Pathology revealed MCL with mantle zone growth pattern in the right thyroid. Flow cytometry showed monoclonal B cells comprising 9% of total cells. The Ki-67 index was 10%. She was diagnosed as having stage IIE MCL and offered conservative management by medical oncology, given that she had no B symptoms. Conclusion. Though chemotherapy is the treatment of choice in MCL, a subset of patients with low-grade disease may be observed. As in our patient, mantle zone growth pattern and a Ki-67 index < 10% suggest a favorable prognosis. A diagnosis of primary MCL in the thyroid remains rare and staging modalities as well as treatment options continue to evolve.