Content overview

What is it?

How does it present?

How is the diagnosis made?

How are thyroid lymphomas treated?

Follow up

What is it? 

Lymphoma of the thyroid is a rare and varied disease which can have multiple forms. Lymphomas are cancers that come from lymphocytes, which are the cells in our body that fight infection and are found mainly in the blood and in lymph nodes. 

Thyroid lymphoma usually occurs within a thyroid gland that already has an autoimmune disease, e.g. autoimmune thyroiditis (or Hashimoto’s thyroiditis) with TPO (thyroid peroxidase) autoantibodies in the blood.

The majority of thyroid lymphomas are Non-Hodgkin B-cell lymphomas and the main types are listed below :

• Diffuse large B cell lymphoma with marginal zone
• Diffuse large B cell lymphoma without marginal zone
• Marginal zone B cell lymphoma of mucosa - associated lymphoid tissue (MALT ): MALT cell lymphoma
• Follicular lymphoma 

How does it present?

Thyroid lymphoma usually either presents with an enlarging nodule in the thyroid, enlarging of the whole thyroid gland, or in a lymph node in the neck. Sometimes these changes may present slowly and sometimes they grow rapidly.

How is the diagnosis made?

For the diagnosis to be made, a biopsy needs to be taken. This may be done with a fine needle aspiration (FNA, or a needle biopsy) where some cells are removed from a thyroid nodule using a thin needle. The cells are then examined under a microscope. However, most lymphomas need more than just an FNA to make a diagnosis and therefore a core biopsy, in which a bigger piece of tissue is taken for examination, is usually preferred.

PET whole body scanning (which includes a radioactive injection plus a CT scan) is likely to be used to understand the true extent of the tumour.

It is important to remember that each person is considered individually, however, and so different thyroid lymphomas may be investigated and diagnosed (treated) differently.

How are thyroid lymphomas treated?

Almost all thyroid lymphomas are treated with specific chemotherapy and/or radiotherapy regimes.

In rare cases, a MALT cell lymphoma is present only in a nodule in the thyroid, and this can be treated with surgery (either hemithyroidectomy or total thyroidectomy).

If the lymphoma is found in the lymph nodes, surgery is not usually advised (unless for diagnostic/biopsy reasons) and radiotherapy and chemotherapy are likely to be used as treatments.

Your doctor should involve a specialist haematology oncologist as soon as possible for advice. Your case should also be considered by a cancer multidisciplinary meeting so that the right diagnostic and treatment plan is made.   

Follow up

Follow up will usually be undertaken by a specialist haematology oncologist and their nursing team.

Some of the treatments may affect how well your thyroid works and therefore your thyroid function should be monitored and thyroid hormone replacement (levothyroxine) started as required.

March 2026