Thyroid Lymphoma - Erler Zimmer 3D anatomy Series MP2100

This dissection model highlighting Thyroid Lymphoma is part of the exclusive Monash 3D anatomy series, a comprehensive series of human dissections reproduced with ultra-high resolution color 3D printing.

Clinical History.

A 68-year-old woman presented with a small hard nodule in her thyroid gland. Over the next six weeks, there was progressive and rapid enlargement of the mass leading to laryngeal stridor and esophageal obstruction, which were the terminal features. No lymph nodes were enlarged and there was no splenomegaly.

Pathology

The larynx, thyroid gland, upper trachea and esophagus are included in the specimen. The enlarged left lobe and, to a lesser extent, the right lobe of the thyroid are replaced by homogeneous pale tumor tissue. Elongated on the lateral margin of the left lobe is the common carotid artery. Note on the internal appearance as the larynx is compressed and the esophagus virtually disappears in most of the tumor. The histological appearance of the tumor was compatible with lymphoblastic lymphoma of the thyroid gland. The rarity of this tumor makes it necessary to exclude the diagnosis of anaplastic thyroid carcinoma and secondary spread from lymphoma elsewhere.

Additional Information.

Primary thyroid lymphoma is rare but should always be considered as a differential diagnosis of any thyroid mass or node. Primary thyroid lymphomas are rare and are usually non-Hodgkin's type. Lymphoblastic lymphoma is an aggressive form of non-Hodgkin's lymphoma (NHL), usually seen in children. Currently, the only known risk factor for the development of primary thyroid lymphoma is chronic autoimmune thyroiditis (Hashimoto's), with a 50% occurrence rate.

Thyroid lymphoma should be considered in any individual presenting with a rapidly enlarging "goiter," as more than 90 percent of individuals with this disease present this way. As the goiter enlarges, there may be compression of nearby structures such as the trachea, esophagus, and neck vessels (the common carotid artery in this case). Resulting symptoms include stridor or hoarseness, dysphagia, and neck pain. Other systemic symptoms of lymphoma include so-called B symptoms, namely night sweats, fevers, and weight loss.
Diagnosis can be obtained by ultrasound followed by fine-needle aspiration or excisional biopsy. Because thyroid lymphomas cannot be excluded from Hashimoto's or other carcinomas, cytology and immunohistochemical staining of biopsied tissue is required to confirm the diagnosis.

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What advantages does the Monash University anatomical dissection collection offer over plastic models or plastinated human specimens?

• Each body replica has been carefully created from selected patient X-ray data or human cadaver specimens selected by a highly trained team of anatomists at the Monash University Center for Human Anatomy Education to illustrate a range of clinically important areas of anatomy with a quality and fidelity that cannot be achieved with conventional anatomical models-this is real anatomy, not stylized anatomy.
• Each body replica has been rigorously checked by a team of highly trained anatomists at the Center for Human Anatomy Education, Monash University, to ensure the anatomical accuracy of the final product.
• The body replicas are not real human tissue and therefore not subject to any barriers of transportation, import, or use in educational facilities that do not hold an anatomy license. The Monash 3D Anatomy dissection series avoids these and other ethical issues that are raised when dealing with plastinated human remains.