Primary Thyroid Lymphoma (PTL) is a rare type of cancer that originates in the thyroid gland due to the uncontrolled growth of abnormal lymphocytes (white blood cells). The thyroid, a small gland in the neck, produces hormones that regulate various bodily functions. PTL is more common in women than men and is most frequently diagnosed in older adults between the ages of 65 and 75.
Causes
The exact cause of Primary Thyroid Lymphoma remains unknown, but it is strongly linked to Hashimoto’s thyroiditis, an autoimmune condition where the immune system attacks the thyroid. While the overall risk is low, individuals with Hashimoto’s thyroiditis are 40 to 80 times more likely to develop PTL than those without the condition.
Signs and Symptoms
Patients with PTL may experience the following symptoms:
- Swelling of the thyroid gland, leading to neck swelling
- A palpable lump or mass in the neck
- Shortness of breath or difficulty breathing
- Hoarseness or voice changes
- Facial swelling
- Persistent fatigue
- Night-time fever
- Excessive sweating at night
- Unintentional weight loss
Diagnosis
PTL is diagnosed using several techniques, including:
- Physical Examination: The throat, neck, and chest are checked for lumps or masses.
- Imaging Tests: CT scans, MRIs, and X-rays help determine the tumour’s location, size, and extent. CT scans can also assess whether the cancer has spread.
- Biopsy: A small tissue sample is taken and examined in a laboratory to confirm the presence of cancer. This may involve cutting or removing part of the suspicious tissue.
- Tumour Markers: Specific substances in the blood may indicate cancer.
- USG-Guided Fine Needle Aspiration Cytology (FNAC): A minimally invasive technique where a thin needle extracts tissue for testing under ultrasound guidance.
- Blood Tests: Thyroid function tests (TSH, T3, and T4) help assess thyroid activity.
- Staging Tests: Performed to determine whether the cancer has spread beyond the thyroid.
Treatment Options
Treatment for PTL depends on the tumour’s size, stage, and spread. The primary options include:
- Surgery: The preferred treatment involves removing the tumour along with surrounding healthy tissue (clear margins). Surgery is most effective for localised cases.
- Radiation Therapy: Often used after surgery to reduce the risk of recurrence, radiation therapy destroys any remaining cancer cells. It is also an alternative for patients who cannot undergo surgery.
- Chemotherapy: Used primarily for advanced or metastatic cases where the cancer has spread. A combination of drugs, such as the CHOP regimen (Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone), is commonly used.
- Immunotherapy and Targeted Therapy: These treatments help the immune system recognise and attack cancer cells more effectively.
Prognosis (Outlook)
PTL generally responds well to treatment, particularly when detected early. The average survival rate ranges from 7.5 to 10 years, depending on the stage and type of lymphoma.
If you notice a lump in your neck or experience difficulty swallowing, seek medical attention immediately. Early detection significantly improves treatment outcomes!
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