Diagnostic Challenges in a Case of Huge Primary Thyroid Lymphoma with Airway Compression: A Case Report

Primary thyroid lymphoma (PTL) is a rare malignancy that can present with rapidly progressive airway compression, posing diagnostic and therapeutic challenges. Here, we report a case of a 75-year-old woman with a rapidly enlarging thyroid mass causing severe dyspnea. Multiple fine-needle aspirations and core biopsies were inconclusive, necessitating surgical intervention. Due to the high risk of airway obstruction, extensive airway management strategies, including extracorporeal membrane oxygenation backup, were prepared. Total thyroidectomy revealed diffuse large B-cell lymphoma, which showed a significant response to subsequent chemoimmunotherapy. This case report highlights the limitations of biopsy techniques in diagnosing PTL, the critical role of airway management, and the importance of a multidisciplinary approach in such life-threatening scenarios.