Mucosa-associated lymphoid tissue lymphoma with large cell transformation on the background of Hashimoto's thyroiditis: a case report and review literature.

Primary thyroid lymphoma (PTL) is a rare cause of malignancy that occurs in 0.5% of cases with Hashimoto's thyroiditis. The most common subtype is diffuse large B-cell lymphoma (DLBCL), followed by mucosa-associated lymphoid tissue (MALT) lymphoma. We described the case of a 70-year-old man who was diagnosed with MALT lymphoma in the background of autoimmune thyroiditis with focal area of DLBCL transformation. The patient was a 70-year-old man with rapidly growing mass of the thyroid gland with compressive symptom over two months. The laboratory data revealed primary hypothyroidism with positively anti-thyroid antibodies. The computerized tomography scan showed right thyroid mass extended to anterior mediastinum and compressed adjacent airway with multiple cervical and mediastinal lymphadenopathies. The pathology from incisional biopsy showed extranodal marginal zone B-cell lymphoma of MALT lymphoma with large cell transformation. The patient received four courses of systemic chemotherapy combined with involved field radiation therapy. The mass was dramatically decreased in size after treatment, leading to a complete resolution of compressive symptoms. Thyroid lymphoma is quite rare; however the incidence may be higher in patients with Hashimoto's thyroiditis. A rapidly growing thyroid gland should be considered as PTL. Chemotherapy and radiation are the mainstays of treatment.

The comparative study of diabetic specific formula and standard formula on postprandial plasma glucose control in type 2 DM patients.

OBJECTIVE: To compare the postprandial plasma glucose level after diabetic specific formula (DSF) and standard formula (SF) administration in type 2 diabetic patients. MATERIAL AND METHOD: Thirty type 2 diabetic patients were included in the present randomized, controlled, double-blind, cross-over study. Subjects received DSF and isocaloric SF as a bolus administration of 400 mL while continuing their anti-diabetic medications. Venous blood samples were collected and analyzed to assess plasma glucose levels at pre- and at 30, 60, 90, 120, and 180 min post-administration of the formulas. RESULTS: Postprandial glucose profiles were significantly lower with DSF compared to SF administration determined as a mean glucose concentration at 2-hour post-administration. The glucose area under the curve (AUC) after DSF consumption was 33% lower than the AUC after SF consumption, p < 0.001. CONCLUSION: Use of DSF resulted in a significantly lower postprandial rise in plasma glucose concentrations than using SF. It should be the preferred option in diabetic patients who need nutritional support.