فهرست نشریات علمی دسترسی آزاد ایران

Primary thyroid lymphoma is rare, with the majority of cases being non-Hodgkin and occurs in patients with autoimmune thyroid disease. Primary thyroid Hodgkin’s lymphoma is extremely rare and only about 20 previous cases have been reported. We report a 24-year-old woman presented with one month history of fever and anterior neck pain. She had left side thyroid enlargement and tenderness, high erythrocyte sedimentation rate, suppressed thyroid stimulating hormone and elevated free thyroxine. Thyroid technetium scan revealed low uptake in left lobe of thyroid compatible with subacute thyroiditis. Initially she was treated with prednisolone without any clinical response. Fine needle aspiration of thyroid was performed which was in favor of malignancy. She underwent left thyroid lobectomy. Pathology and immunohistochemistry investigations showed classical Hodgkin’s lymphoma. Imaging studies revealed no extra thyroid involvement. She received chemotherapy with good response and has been disease free in past seven years. Although anaplastic thyroid carcinoma, non-Hodgkin lymphoma and metastasis to the thyroid can mimic subacute thyroiditis, this is the first reported case of primary Hodgkin’s lymphoma with such presentation. We conclude that in patients with subacute thyroiditis and poor response to treatment, malignancies including Hodgkin’s lymphoma should be considered. Early tissue diagnosis leads to timely initiation of treatment and better prognosis.