Clinicopathological features of primary thyroid Burkitt's lymphoma: a systematic review and meta-analysis

Diagn Pathol. 2020 Feb 8;15(1):13. doi: 10.1186/s13000-020-00933-z.

Abstract

Background: Primary thyroid Burkitt's lymphoma (BL) is an extremely rare and highly aggressive form of non-Hodgkin's lymphoma; only isolated case reports are available for patients with this disease.

Methods: We analyzed the clinicopathological features of thyroid BL by conducting a meta-analysis of 21 known patients (including ours) and compared them to those of extrathyroidal BL.

Results: There were 13 men and 8 women with a median age of 39.3 years (range, 6-75 years). The median follow-up was 46.5 months (range, 0.5-361 months). Six patients (28.6%) had stage I disease, 2 (9.5%) had stage II, 2 (9.5%) had stage III, and 11 (52.4%) had stage IV. Five of 7 tested patients with thyroid BL (71.4%) had histological evidence of underlying Hashimoto's thyroiditis. Ki-67 labeling indices exceeding 90% in all 19 patients tested (100%). Fluorescence in situ hybridization performed on 12 patient samples revealed that all (100%) had MYC rearrangement. Among the 16 patients for whom follow-up data were available, 4 died of disease-related causes. Kaplan-Meier analysis revealed that the 12- and 60-month overall survival rates for patients with thyroid BL were 87.5 and 70.7%, respectively.

Conclusions: Ours was the largest study of thyroid BL and its detailed clinicopathological features to date. Thyroid BL is not associated with underlying Epstein-Barr virus infection but is closely linked to Hashimoto's thyroiditis; patients generally have good overall survival and respond well to intensive chemotherapy. The correct pathological diagnosis is essential for treatment selection and outcome improvement.

Keywords: Clinicopathological features; Hashimoto’s thyroiditis; Meta-analysis; Thyroid Burkitt’s lymphoma.

Publication types

  • Case Reports
  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Burkitt Lymphoma / diagnosis
  • Burkitt Lymphoma / mortality*
  • Burkitt Lymphoma / pathology*
  • Child
  • Female
  • Herpesvirus 4, Human / pathogenicity*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Survival Rate
  • Thyroid Gland / pathology*
  • Young Adult