{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T13:18:13Z","timestamp":1778591893729,"version":"3.51.4"},"reference-count":31,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health\u2019s Current Research program"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Primary thyroid lymphoma (PTL) is a rare malignancy, accounting for less than 5% of thyroid cancers and less than 2% of extranodal lymphomas. It predominantly affects older women and is strongly associated with autoimmune thyroiditis, particularly Hashimoto\u2019s thyroiditis. Diagnosis is often challenging due to non-specific clinical, imaging, and cytological findings, and the role of surgery has progressively shifted from therapeutic to primarily diagnostic. Methods: We conducted a retrospective single-center case series including nine patients treated for PTL between 2015 and 2025 at a tertiary referral endocrine surgery center. An analysis was conducted on clinical presentation, pre-existing thyroid disease, diagnostic work-up, histopathological subtypes, treatment strategies and outcomes. All patients underwent preoperative ultrasound and fine-needle aspiration cytology (FNAC); surgical intervention was performed to confirm cytology results, when cytology was inconclusive or when compressive symptoms were present. Results: The cohort included six females and three males, with a median age of 65.2 years. Four patients had Hashimoto\u2019s thyroiditis and three had multinodular goiter. FNAC was diagnostic or suggestive of lymphoma in three cases only, and surgical biopsy or thyroidectomy for a definitive diagnosis was performed in eight cases. One case started follow-up after cytology and flow cytometry. Histological subtypes were heterogeneous, including diffuse large B-cell lymphoma, Burkitt\u2019s lymphoma, Hodgkin lymphoma, follicular lymphoma, high-grade B-cell lymphoma, and MALT lymphoma. Seven patients received combined chemoimmunotherapy. A complete response was obtained in eight patients, with a minimum follow-up of three years; one patient died of unrelated causes. Conclusions: PTL remains a rare and diagnostically challenging thyroid malignancy. FNAC alone is frequently insufficient, and surgical biopsy retains an important role in cases with high clinical suspicion or compressive symptoms. While surgery has limited therapeutic value, a multidisciplinary approach and timely, tailored treatment are crucial to achieving favorable outcomes.<\/jats:p>","DOI":"10.3390\/cancers18101574","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T12:33:37Z","timestamp":1778589217000},"page":"1574","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Features of Thyroid Lymphoma: A Single-Center Experience"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4781-8013","authenticated-orcid":false,"given":"Enrico","family":"Battistella","sequence":"first","affiliation":[{"name":"Endocrine Surgery Unit, Department of Surgery, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Pomba","sequence":"additional","affiliation":[{"name":"Endocrine Surgery Unit, Department of Surgery, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Toniato","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Padua, Via Giustiniani 2, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Piotto","sequence":"additional","affiliation":[{"name":"Endocrine Surgery Unit, Department of Surgery, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2032-2085","authenticated-orcid":false,"given":"Ivana","family":"Cataldo","sequence":"additional","affiliation":[{"name":"Anatomy and Pathological Histology Unit, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariella","family":"Lo Schirico","sequence":"additional","affiliation":[{"name":"Onco-Hematology, Department of Oncology, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Toniato","sequence":"additional","affiliation":[{"name":"Endocrine Surgery Unit, Department of Surgery, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.endonu.2014.04.007","article-title":"Linfoma primario del tiroides Primary thyroid lymphoma","volume":"61","author":"Febrero","year":"2014","journal-title":"Endocrinol. Nutr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1097\/MOO.0000000000000875","article-title":"Thyroid lymphoma","volume":"31","author":"Rovira","year":"2023","journal-title":"Curr. Opin. Otolaryngol. Head Neck Surg."},{"key":"ref_3","first-page":"316","article-title":"Primary Thyroid Lymphoma","volume":"26","author":"Ansell","year":"1999","journal-title":"Semin. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1016\/j.surg.2009.09.020","article-title":"Prognosis of primary thyroid lymphoma: Demographic, clinical, and pathologic predictors of survival in 1,408 cases","volume":"146","author":"Roman","year":"2009","journal-title":"Surgery"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1111\/j.1365-2141.2011.08606.x","article-title":"Clinicopathological features of 171 cases of primary thyroid lymphoma: A long-term study involving 24 553 patients with Hashimoto\u2019s disease","volume":"153","author":"Watanabe","year":"2011","journal-title":"Br. J. Haematol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1089\/thy.2021.0613","article-title":"The Relationship Between Primary Thyroid Lymphoma and Various Types of Thyroid Autoimmunity: A Retrospective Cohort Study of 498 Cases, Including 9 Cases with Graves\u2019 Disease","volume":"32","author":"Suzuki","year":"2022","journal-title":"Thyroid\u00ae"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"240","DOI":"10.3816\/CLM.2005.n.052","article-title":"Treatment and Survival of Patients with Thyroid Lymphoma: A Population-Based Study with Clinical and Pathologic Reviews","volume":"6","author":"Snijder","year":"2005","journal-title":"Clin. Lymphoma Myeloma"},{"key":"ref_8","first-page":"442","article-title":"[Malt lymphoma of the thyroid and Graves\u2019disease]","volume":"62","author":"Djrolo","year":"2001","journal-title":"Ann. D\u2019endocrinologie"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1089\/thy.2004.14.772","article-title":"Primary thyroid lymphoma associated with Graves\u2019 disease","volume":"14","author":"Doi","year":"2004","journal-title":"Thyroid\u00ae"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1507\/endocrj1954.32.435","article-title":"Primary malignant lymphoma of the thyroid in a patient with long-standing Graves\u2019 disease","volume":"32","author":"Zeki","year":"1985","journal-title":"Endocrinol. Jpn."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1080\/20009666.2020.1829403","article-title":"Non-Hodgkin lymphoma of the thyroid in a patient with hyperthyroidism","volume":"11","author":"Lanham","year":"2021","journal-title":"J. Community Hosp. Intern. Med. Perspect."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1007\/s13193-022-01515-9","article-title":"Hashimoto\u2019s Thyroiditis and Papillary Cancer Thyroid Coexistence Exerts a Protective Effect: A Single Centre Experience","volume":"13","author":"Battistella","year":"2022","journal-title":"Indian J. Surg. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Lee, J.S., Shin, S.-J., Yun, H.J., Kim, S.M., Chang, H., Lee, Y.S., and Chang, H.-S. (2023). Primary thyroid lymphoma: A single-center experience. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1064050"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1177\/019459988910000413","article-title":"Emergency surgery for primary lymphoma of the thyroid","volume":"100","author":"Albu","year":"1989","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1245\/s10434-023-14535-8","article-title":"Surgery is a Viable Treatment Option for Stage IE Primary Thyroid Lymphoma","volume":"31","author":"Tang","year":"2024","journal-title":"Ann. Surg. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1007\/s00423-023-02945-x","article-title":"Diagnosis and treatment of primary thyroid lymphoma from a surgical perspective: A multi-institutional study","volume":"408","year":"2023","journal-title":"Langenbeck\u2019s Arch. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1016\/j.annonc.2025.07.014","article-title":"Lymphomas: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"36","author":"Eyre","year":"2025","journal-title":"Ann. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"659","DOI":"10.5603\/ep.108654","article-title":"Primary thyroid lymphoma: A tertiary-center experience","volume":"76","author":"Antunes","year":"2025","journal-title":"Endokrynol. Pol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1089\/thy.1993.3.93","article-title":"Clinical Aspects of Primary Thyroid Lymphoma: Diagnosis and Treatment Based on Our Experience of 119 Cases","volume":"3","author":"Matsuzuka","year":"1993","journal-title":"Thyroid\u00ae"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1177\/10507256251393514","article-title":"Survival Outcomes and Treatment Strategies in Primary Thyroid Lymphoma: A Population-Based Study of 401 Cases from the Tokyo Cancer Registry","volume":"35","author":"Saito","year":"2025","journal-title":"Thyroid\u00ae"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3497","DOI":"10.1038\/s41375-021-01289-z","article-title":"Thyroid MALT lymphoma: Self-harm to gain potential T-cell help","volume":"35","author":"Wu","year":"2021","journal-title":"Leukemia"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1507\/endocrj.EJ17-0111","article-title":"Preoperative diagnostic algorithm of primary thyroid lymphoma using ultrasound, aspiration cytology, and flow cytometry","volume":"64","author":"Hirokawa","year":"2017","journal-title":"Endocr. J."},{"key":"ref_23","first-page":"48","article-title":"Fine Needle Aspiration Cytology and Immunocytochemistry in the Diagnosis of Lymphoid Lesions of the Thyroid-Gland","volume":"33","author":"Tani","year":"1989","journal-title":"Acta Cytol."},{"key":"ref_24","first-page":"385","article-title":"Ultrasound scanning in diagnosing primary thyroid lymphoma","volume":"88","author":"Xue","year":"2024","journal-title":"Clin. Hemorheol. Microcirc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1002\/dc.2840030314","article-title":"Fine-needle aspiration cytology of malignant lymphoma of the thyroid","volume":"3","author":"Matsuda","year":"1987","journal-title":"Diagn. Cytopathol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1046\/j.1365-2303.2001.00338.x","article-title":"Fine needle aspiration cytology of primary lymphoma of the thyroid: A report of 17 cases","volume":"12","author":"Sangalli","year":"2001","journal-title":"Cytopathology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1007\/BF02067333","article-title":"Non-Hodgkin\u2019s lymphoma of the thyroid: Is more than biopsy necessary?","volume":"16","author":"Pyke","year":"1992","journal-title":"World J. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.amsu.2016.12.023","article-title":"Primary thyroid lymphoma: A case report and review of the literature","volume":"13","author":"Peixoto","year":"2017","journal-title":"Ann. Med. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Jaafari, A., Mehaudens, S., Gheysens, O., Bailly, S., Schobbens, N., Mourad, M., and Jamar, F. (2025). Massive Primary Thyroid Lymphoma on [18F]-FDG-PET\/CT: A Literature Review of a Rare Case of Rapidly Progressive Goitre. Diagnostics, 15.","DOI":"10.3390\/diagnostics15172180"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1007\/s13304-011-0060-0","article-title":"Features of Papillary Thyroid Carcinoma in Patients Older than 75 Years","volume":"63","author":"Toniato","year":"2011","journal-title":"Updates Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s11864-004-0021-7","article-title":"Primary thyroid lymphomas","volume":"5","author":"Widder","year":"2004","journal-title":"Curr. Treat. Options Oncol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/10\/1574\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T13:03:44Z","timestamp":1778591024000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/10\/1574"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,12]]},"references-count":31,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["cancers18101574"],"URL":"https:\/\/doi.org\/10.3390\/cancers18101574","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,12]]}}}