To report a rare case of intravascular large B-cell lymphoma (IVLBCL) confined to thyroid nodules and to raise awareness among pathologists regarding its diagnostic challenges.
Approach:
Case Presentation: A 63-year-old female presented with bilateral goiter and underwent thyroid ultrasonography, revealing multiple nodules. Laboratory tests showed mild abnormalities, and she underwent bilateral thyroidectomy.
Pathological Examination: Initial diagnosis was simple nodular goiter, but re-examination revealed atypical lymphoid elements in the interfollicular spaces, indicating IVLBCL.
Key Findings:
IVLBCL was confined to nodular goiter tissue without invasion of adjacent normal thyroid parenchyma or lymph nodes.
Peripheral blood circulating tumor cell detection and EBER staining were negative.
Tumor cells were scattered in the intervals of thyroid follicles, mimicking inflammatory lesions.
Interpretation:
The unique growth pattern of IVLBCL within nodular goiter can lead to diagnostic challenges.
Limitations:
The rarity of IVLBCL in the thyroid limits generalizability.
The case highlights the potential for misdiagnosis due to the tumor's concealed growth pattern.
Conclusion:
Early diagnosis and timely chemotherapy are crucial for improving patient outcomes in IVLBCL.
