Malignant lymphoproliferative disease of the thyroid gland is called lymphoma. Allocate primary and secondary lesions of the thyroid tissue. The primary lesion accounts for up to 8% of all thyroid tumors. The secondary lesion manifests itself in other lesions, with the development of such lymphoid lesions as leukemia and lymphoma. Thyroid lymphoma affects 3 times more often than women, predominantly over the age of 60.
Thyroid lymphoma. Causes of this thyroid disease
To date, it has been proven that thyroid lymphoma occurs against the background of such a thyroid disease as Hashimoto's thyroiditis. This is confirmed by the fact that in 85% of cases of detection of lymphoma in the anamnesis there is an autoimmune thyroiditis. Such thyroid disease must be confirmed immunologically and histologically. It is assumed that in the process of prolonged stimulation of glandular lymphocytes with antigens, they are transformed into lymphoma.
When lymphoma is detected in a patient who does not have a history of autoimmune thyroiditis, ionizing radiation, viruses, chemical carcinogens and adverse environmental conditions are considered to be the causative factor, which undoubtedly affect the development of thyroid disease.
Lymphoma has a rapid growth with the formation of diffuse nodes. These nodes greatly increase the size of the thyroid gland, occupying a significant part of it. Often the lymph nodes are also involved in the pathological process. As a rule, thyroid lymphoma develops against the background of hypothyroidism.
Symptoms of dangerous thyroid disease – lymphomas
The development of lymphoma occurs in a short time and is characterized by the rapid growth of thyroid tissue. Patients notice an increase in the size of the thyroid gland themselves and go to the doctor to identify thyroid diseases. The formation has a wooden density, and unilateral lesions often occur. Palpation lymphoma is not displaced relative to other anatomical structures.
The growth of lymphoma is infiltrating, due to which the surrounding tissues are compressed. This leads to invasion and compression of neighboring formations. Such growth is accompanied by paresis of the larynx, dysphonia, paralysis of the vocal folds, displacement of the esophagus and trachea.
In the development of a thyroid disease such as lymphoma, the function of the gland is often reduced, while the state of hypothyroidism develops in only half of the cases. Already at the beginning of the growth of lymphoma, there are signs of intoxication, fever, severe night sweats, cachexia, severe increasing weakness.
Diagnosis and treatment of thyroid in lymphoma
The patient himself can first of all suspect the formation of lymphoma due to an increase in the formation and the neck as a whole. The diagnosis is confirmed by fine needle aspiration biopsy, followed by immunological and cytological examination of the biopsy.
Thyroid treatment is started after the diagnosis has been clarified. In order to clarify the diagnosis, a biochemical blood test is performed with the determination of the level of lactic acid dehydrogenase and uric acid, the determination of titers of thyroid hormones.
Visualization of the tumor is carried out using the methods of ultrasound, CT, radiography. In certain cases, sternal puncture and trepanobiopsy are performed to rule out bone marrow metastasis.
Differential diagnosis is with thyroid cancer, autoimmune thyroiditis, and thyroid nodules.
The treatment of the thyroid gland in a patient with lymphoma depends on the extent of the process and its morphology. In the presence of a local type of lymphoma, thyroidectomy with lymph node dissection is performed, which is supplemented by polychemotherapy or radiation therapy. After that, immunocorrection of hypoparathyroidism is carried out.
For advanced lymphoma, chemotherapy or combination chemoradiotherapy is given. Such combination therapy allows to achieve an increase in 5-year survival up to 90% without relapses. Therefore, this scheme is the standard in the treatment of the thyroid gland in lymphoma.
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