Résumé
Background: Primary Thyroid Lymphoma (PTL) is uncommon, accounting for only 5% of thyroid neoplasms and less than 2.5 to 7% of extranodal lymphomas. The study aims to analyze the histopathological findings and to correlate it with clinical features. Methods: This study includes cases of PTL received in the department of pathology in a tertiary care center, Kerala, south India over a period of 5 years. Patient details and follow up data were obtained by communication with treating doctors and reviewing the hospital records. All cases had a minimum follow up of 6 months. Results: 15 cases of PTL were diagnosed over the five year period. In total 72 cases of extranodal lymphomas were diagnosed, thus forming 20.83% of extra nodal lymphomas. Lymphocytic thyroiditis was present in 93.3%. Most of the cases were Extranodal Marginal Zone B Cell Lymphoma (EMZBCL) and Diffuse Large B Cell Lymphoma (DLBCL). Conclusion: It is important to consider the diagnosis of primary thyroid lymphoma in patients presenting with an enlarging neck mass especially with the history of Hashimoto’s thyroiditis. Random microscopic foci of DLBCL or small areas of MZBL could be overlooked examination or missed with limited sampling. The distinction between MZBL and DLBCL in the thyroid is clinically significant.
Résumé
Background: Cases of carcinoma breast with TNM stage 3 are considered as locally advanced breast cancer. This study was done to demonstrate the effect of neoadjuvant chemotherapy in cases of stage 3 technically inoperable breast cancers. As neoadjuvant chemotherapy is an already established form of treatment, its effect on ‘complete clinical response and pathological response’ were studied. Methods: This prospective study was carried out in department of general surgery of Medical college, Thiruvananthapuram after obtaining approval from research ethical committee. Relevant data of chemotherapy was collected from department of Radiotherapy and Histopathological data was collected from department of Pathology. 25 cases of locally advanced breast carcinoma were studied. These patients were started on treatment with FAC regime and the response was assessed. Results: In this study 20% of patients had complete clinical response at the completion of 3 cycles of chemotherapy with FAC regime. 48% had partial response. In 32% of patients, stasis was observed. None showed increase in tumor size during treatment. Conclusion: The study demonstrated the effectiveness of neoadjuvant chemotherapy in downstaging the tumor enabling definitive surgery with less morbidity. It also showed a complete clinical and pathological response in a significant number of patients.