Primary Thyroid Diffuse Large B-Cell Lymphoma with Spindle Cell Morphology: A Case Report

A Diffuse Large B-Cell Lymphoma (DLBCL) with spindle cell components is extremely rare and often misdiagnosed as a carcinoma or sarcoma. Here, we present a case of primary DLBCL with a spindle cell morphology arising in the thyroid, for which needle cytology was unsuccessful for obtaining a preoperative diagnosis. An 82-year-old female was examined for a rapid enlarging mass in the anterior neck area and computed tomography scanning showed a tumor that was 40 mm in size, without cyst or calcification. A left partial thyroidectomy was performed, followed by histological examinations revealed. Microscopy findings of the resected thyroid tumor revealed a diffuse or epithelioid pattern of round and polygonal cells mixed with the fascicles of spindle cells. In immunohistochemical results, all types of tumor cells showed positive staining for CD45, CD20, CD79a, CD10, and bcl-2, and were negative for CKAE1/AE3, TTF-1, MUN-1, CD3, CD5, bcl-2, IRTA-1, cyclin D1, c-myc, and EBER. Furthermore, a lymphocyte marker (CD45), B-cell markers (CD20 and CD79α). A lymphoma with spindle cell morphology is quite uncommon, and this variant can be difficult to diagnose. The present findings emphasized that pathologists remain aware of a possible lymphoma for a differential diagnosis of tumors with spindle cell components.

[1]  J. Woodroof,et al.  Extranodal B Cell Lymphoma with Prominent Spindle Cell Features Arising in Uterus and in Maxillary Sinus: Report of Two Cases and Literature Review. , 2016, Annals of clinical and laboratory science.

[2]  A. Wienke,et al.  Primary Thyroid Sarcoma: A Systematic Review. , 2015, Anticancer research.

[3]  Shou-jing Yang,et al.  Sarcomatoid variant of ALK- anaplastic large cell lymphoma involving multiple lymph nodes and both lungs with production of proinflammatory cytokines: report of a case and review of literature. , 2014, International journal of clinical and experimental pathology.

[4]  P. Dey,et al.  Fine needle aspiration cytology of spindle cell variant of diffuse large B‐cell lymphoma: a diagnostic dilemma , 2008, Cytopathology : official journal of the British Society for Clinical Cytology.

[5]  Y. Higami,et al.  Primary hepatic lymphoma with spindle cell components: a case report , 2006, Virchows Archiv.

[6]  K. Chang,et al.  Histological and immunohistochemical characterization of extranodal diffuse large‐cell lymphomas with prominent spindle cell features , 2001, Histopathology.

[7]  L. Weiss,et al.  Diffuse large B‐cell lymphoma with spindle cell features , 2001, Histopathology.

[8]  H. Kerl,et al.  Cutaneous Spindle-Cell B-Cell Lymphoma: A Morphologic Variant of Cutaneous Large B-Cell Lymphoma , 2000, The American Journal of dermatopathology.

[9]  R. Fonseca,et al.  Follicular dendritic cell sarcoma mimicking diffuse large cell lymphoma: A case report , 1997, American journal of hematology.

[10]  C. H. Fung,et al.  Actin-positive spindle cell lymphoma. , 1993, Archives of pathology & laboratory medicine.

[11]  C. Fletcher,et al.  Sarcomatoid variant of anaplastic large-cell Ki-1 lymphoma. , 1990, The American journal of surgical pathology.

[12]  S. Weiss,et al.  Malignant Lymphoma: A Study of 75 Cases Presenting in Soft Tissue , 1989, The American journal of surgical pathology.

[13]  J. Berg,et al.  Occurrence and prognosis of extranodal lymphomas , 1972, Cancer.