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Cancer in the thyroid is not always thyroid cancer.

Katherine E KE Akester, Noel N Somasundaram, Salvador S Diaz-Cano, and Ashley B AB Grossman

Hormones (Athens) 2(4):250-5 (2003) PMID 17003029

Most clinicians assume that a thyroid mass which appears to be malignant is most likely a tumour arising from thyroid cells. We present a case where the thyroid malignancy was associated with a degree of systemic clinical and biochemical disturbance which suggested alternative diagnoses, and in which fine-needle aspiration revealed that the patient had a thyroid lymphoma. Gastric biopsy showed that this was a primary gastric diffuse B cell lymphoma. Subsequent management provided a number of challenging and overlapping problems, and the patient eventually died from this high-grade malignancy. We review the prevalence, presentation, diagnosis and management of lymphomas presenting as thyroid masses, and underline the problems in management when there is multi-system disease.

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