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Preparation of future physicians for participation in the identification of the deceased: justification of an educational need in wartime conditions
No full textIntroduction. The full-scale war against Ukraine has caused a dramatic rise in unidentified bodies and missing persons, placing exceptional strain on forensic services, DNA laboratories, and units responsible for documentation of the deceased. International INTERPOL DVI standards and post-conflict experience (e.g., Croatia, Cyprus) show that successful identification depends not only on forensic specialists but also on the broad involvement of physicians who provide high-quality antemortem data.
Methods. We reviewed international regulatory documents (INTERPOL, ICMP, ICRC), relevant literature (published between 2015 and 2024), and comparative educational models from countries with post-conflict identification programs. Content analysis, comparative analysis, structural-logical modelling, and elements of foresight were used to design a scalable educational framework suitable for Ukrainian medical universities.
Results. Evidence indicates that integrating physicians into DVI processes – through improved medical documentation, radiology, dental records, and ethical communication with families –substantially improves identification outcomes. Educational models from Croatia and Cyprus, which combine theoretical instruction with practical placements and multidisciplinary training, effectively prepare students for real-world identification tasks. Key systemic challenges for Ukraine include overloaded forensic services, a shortage of trained personnel, fragmentary medical records, weak interagency coordination, and insufficient psychological preparedness.
Conclusions. We propose a four-level integration model – basic, advanced, clinical-forensic practicum, and postgraduate training – to develop physician competencies in human identification. Implementing structured DVI modules across medical curricula will improve documentation quality, strengthen interdisciplinary cooperation, and enhance national capacity for searching and identifying the deceased – an essential humanitarian and state responsibility during wartime and the post-war period.Повномасштабна війна проти України призвела до безпрецедентного зростання кількості невстановлених тіл та зниклих безвісти, що створило надмірне навантаження на систему судово-медичної експертизи, ДНК-лабораторії та підрозділи, залучені до документування загиблих. Стандарти INTERPOL DVI та досвід країн, які постраждали від масштабних конфліктів, зокрема Хорватії та Кіпру, демонструють, що ефективна ідентифікація загиблих залежить не лише від судово-медичних експертів, а й від широкого залучення лікарів різних спеціальностей, які формують якісні анте-морем дані. У статті висвітлено ключові міжнародні підходи до ідентифікації та підготовки медичних фахівців, з акцентом на міждисциплінарні моделі, що поєднують навчання, практичні навички та гуманітарний компонент у роботі з родинами зниклих осіб.
Автори обґрунтовують необхідність інтеграції структурованих модулів із основ ідентифікації особи до навчальних програм медичних університетів України на всіх рівнях — від додипломної підготовки до післядипломної освіти. Запропонована модель включає теоретичні курси, симуляційні тренінги, практику в судово-медичних установах та навчання принципам роботи в DVI-командах. Її впровадження сприятиме підвищенню якості медичної документації, формуванню міждисциплінарних компетентностей та зміцненню національної системи пошуку й ідентифікації загиблих — важливої складової гуманітарної відповідальності держави як під час війни, так і в період післявоєнного відновлення
Mediterranean Diet Adherence, Body Mass Index, and Quality of Life Among Young Adults: A Cross-Sectional Analysis
No full textIntroduction. Young adulthood is a critical period for establishing dietary habits. This study examined associations among Mediterranean diet (MD) adherence, body mass index (BMI), and quality of life (QoL) in university students.
Methods. A total of 729 students aged 18–30 years were assessed for MD adherence (MEDAS), QoL (SF-36), and anthropometrics. Associations were evaluated using regression analyses and structural equation modeling (SEM).
Results. Among 729 university students (mean age 21.3 ± 2.1 years; 59.1% female), females had higher MEDAS scores than males (7.2 ± 2.0 vs. 6.5 ± 2.2; p < 0.001). Higher MEDAS scores were positively associated with SF-36 physical (B = 1.85) and mental health (B = 1.47), while higher BMI was inversely associated with both domains (physical: B = −0.95; mental: B = −0.78; all p < 0.001). SEM showed acceptable model fit and explained 21% of the variance in the MEDAS, 27% in physical health, and 23% in mental health.
Conclusions. Greater MD adherence is associated with better QoL and lower BMI in young adults, supporting the potential value of MD-based dietary behaviors
Analysis of Risk Factors and Construction of a Prediction Model for Pulmonary Atelectasis Complicating Pediatric Severe Pneumonia by Integrating a Quantitative Lung Ultrasound Score with Routine Parameters
No full textIntroduction. To integrate the Lung Ultrasound Score (LUSS) with routine parameters to analyze the risk factors for pulmonary atelectasis in children with severe pneumonia (SP) and to construct a predictive model.
Methods. A retrospective analysis was conducted on 215 children with SP who underwent lung ultrasound examination at the Sixth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China, between September 2022 and June 2025. Based on the occurrence of atelectasis during hospitalization, the patients were categorized into an atelectasis group and a non-atelectasis group. Data collected within 48 hours of admission included general information, clinical data, laboratory parameters, and imaging findings. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors for the development of atelectasis. Subsequently, a nomogram was developed and validated.
Results. Among the 215 children with SP, 75 (34.88%) developed atelectasis. The LUSS, alanine aminotransferase (ALT), and α-hydroxybutyrate dehydrogenase (α-HBDH) were significantly associated with the occurrence of atelectasis complicating SP (p < 0.05). Receiver operating characteristic (ROC) curve analysis of the constructed nomogram model demonstrated that the combination of these three factors for predicting atelectasis yielded a sensitivity of 84.0%, a specificity of 65.0%, and an area under the curve (AUC) of 0.790 (95% CI: 0.728~0.846; p < 0.05). The Hosmer-Lemeshow test yielded a p-value of 0.102, indicating that the model possesses strong predictive capability.
Conclusions. The model established in this study can be utilized to predict the risk of pulmonary atelectasis in children with SP. When children with SP present concurrently with severe lung ultrasound findings and elevated ALT and α-HBDH levels, a high degree of vigilance for the potential development of atelectasis is warranted, necessitating early personalized intervention
Prevalence and Risk Factors of Diabetes and Prediabetes: A Population-Based Survey
No full textIntroduction. Diabetes and prediabetes are major global health concerns, with rising prevalence driven by aging, urbanization, obesity, and sedentary lifestyles. Early identification of at-risk individuals is essential to prevent progression and complications. Data on the epidemiology of diabetes and prediabetes in Duhok City, Iraq, remain scarce.
This study aims to determine the prevalence of diabetes and prediabetes, as well as the associated risk factors, among adults in Duhok City, Iraq.
Methods. A population-based cross-sectional study was conducted in March 2025 among 563 adults selected via multistage random sampling. Data on demographics, lifestyle, medical history, anthropometrics, and blood glucose were collected. Diabetes and prediabetes were diagnosed based on fasting blood glucose, random blood glucose, and glycated hemoglobin levels. Logistic regression was used to estimate odds ratios with 95% confidence intervals for factors associated with prediabetes and diabetes.
Results. The overall prevalence of glycemic abnormalities was 18.1%, including 6.4% with prediabetes and 11.7% with diabetes; 13.6% of diabetes cases were previously undiagnosed. Factors associated with prediabetes were older age and a history of dyslipidemia, whereas factors associated with diabetes included older age, higher body mass index, a history of dyslipidemia, and a family history of diabetes.
Conclusions. One in five adults in Duhok City has prediabetes or diabetes, with a substantial proportion undiagnosed. Older age, higher body mass index, a history of dyslipidemia, and a family history of diabetes are key determinants of diabetes. These findings emphasize the need for targeted screening and early interventions to prevent the progression of diabetes and its complications
Asymmetric Dimethylarginine as a Potential Biomarker for Cardiovascular Risk Assessment in Long-Standing Type 1 Diabetes Mellitus
No full textIntroduction. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, is a marker of endothelial dysfunction and has been linked to vascular injury. Its clinical relevance for cardiovascular risk (CVR) assessment in adults with long-standing type 1 diabetes mellitus (T1DM) remains unclear.
The objective of this study was to examine whether serum ADMA levels relate to established CVR stratification models and to explore their associations with key clinical variables relevant to vascular risk (albuminuria (AlbU), glycated hemoglobin (HbA1c), diabetes duration, and sex).
Methods. This cross-sectional study included 124 adults with long-standing T1DM and 59 age- and sex-matched non-diabetic controls. Serum ADMA was measured by ELISA; C-reactive protein (CRP), HbA1c, and AlbU were quantified using standardized clinical laboratory methods. CVR was assessed using the Steno Type 1 Risk Engine (ST1RE), the 2019 European Society of Cardiology Guidelines on Diabetes, Pre-Diabetes and Cardiovascular Diseases (ESC 2019), and a composite RiskFactor3 model integrating CRP, HbA1c, and AlbU categories. Non-parametric methods were applied due to non-normal distributions.
Results. ADMA levels did not differ significantly between the T1DM and control group (0.49 [0.32–0.68] vs. 0.56 [0.43–0.69] μmol/L, p = 0.092). Within the T1DM cohort, ADMA correlated positively with AlbU (p = 0.004) but showed no meaningful associations with age, diabetes duration, HbA1c, or CRP. A multivariable regression, including AlbU and HbA1c, explained 15% of ADMA variability (p < 0.001). ADMA values overlapped extensively across the ST1RE, ESC 2019, and RiskFactor3 categories. Receiver operating characteristic analyses demonstrated limited overall discriminatory capacity (AUC ≈ 0.5). In females, a trend toward moderate discrimination was observed for identifying ≥ 2 RiskFactor3 components (AUC = 0.653, 95% CI (0.565–0.881), p = 0.067).
Conclusions. Serum ADMA is not a universal marker of global CVR in adults with long-standing T1DM. Its strongest clinical association was with AlbU, consistent with renal-endothelial stress rather than overall CVR burden as defined by multivariable risk equations. The observed sex-specific signal in females warrants further investigation. Larger prospective studies are needed to determine whether ADMA may have targeted value in phenotype-specific or sex-specific CVR assessment strategies
Comprehensive assessment of intestinal anastomosis viability in rectal cancer: fluorescence angiography, inflammatory biomarkers, and morphological verification
No full textIntroduction. Anastomotic leakage (AL) remains one of the most severe postoperative complications in the surgical treatment of rectal cancer. Ischemic microcirculatory disturbances in the anastomotic zone represent a leading factor in the development of this complication and may be exacerbated after neoadjuvant radiotherapy (NRT). Conventional methods for assessing bowel perfusion are largely subjective; therefore, objective intraoperative techniques, particularly indocyanine green (ICG) fluorescence angiography, are gaining increasing importance. In addition, monitoring early inflammatory markers-procalcitonin (PCT) and C-reactive protein (CRP)-in combination with morphological tissue assessment has significant prognostic value for the timely detection of AL.
Aim. To evaluate the relationship between intraoperative intestinal wall perfusion, inflammatory biomarker levels, and morphological signs of ischemia in predicting anastomotic leakage after rectal resection.
Materials and Methods. A prospective cohort study was conducted involving 107 patients with stage I-III rectal cancer who underwent anterior or low anterior resection with colorectal anastomosis. Patients were divided into two groups according to the method of perfusion assessment: the ICG(-) group, which underwent standard visual evaluation, and the ICG(+) group, in which indocyanine green fluorescence angiography was applied. Clinical, morphological, and laboratory parameters (CRP, PCT), as well as instrumental data from intraoperative angiography, were analyzed. Statistical analysis was performed using the Mann–Whitney U test, correlation analysis, and ROC analysis, with a significance level set at p<0.05.
Results. Intraoperative indocyanine green (ICG) fluorescence angiography enabled objective assessment of intestinal wall perfusion and allowed adjustment of resection margins in 20.8% of patients. The use of ICG angiography was associated with a lower incidence of anastomotic leakage (5.6%) compared with the control group (18.1%). In patients with low relative fluorescence intensity (ΔI<25%), morphological signs of ischemic injury of the mucosa were more frequently detected, including edema, crypt destruction, and fibrin thrombi in the submucosal layer, corresponding to grade 2-3 according to the Ischemic Injury Score. Elevated procalcitonin levels above 0.5 ng/mL and C-reactive protein levels above 100 mg/L on the third postoperative day were significantly associated with the development of anastomotic leakage. The combined use of ICG angiography parameters, CRP, PCT, and morphological assessment of ischemia demonstrated high prognostic accuracy for predicting the risk of complications (AUC=0.92).
Conclusions. Intraoperative indocyanine green fluorescence angiography is an effective method for assessing intestinal wall perfusion during rectal resection. The integration of ICG angiography data with procalcitonin and C-reactive protein levels, as well as morphological signs of ischemia, allows a comprehensive evaluation of anastomotic viability and improves the accuracy of predicting anastomotic leakage. This approach contributes to early risk identification in patients and may reduce the incidence of postoperative complications
Determination of the Need for Prosthetic Treatment at Patients with Partial and Complete Absence of Teeth with the Use of Dental Implants
No full textThe purpose of the study is to study the need for prosthetic treatment at patients with partial and complete absence of teeth with the use of dental implants by conducting an examination of patients who asked for dental treatment.
Materials and methods. The article determines the need for prosthetic treatment at patients with partial and complete absence of teeth with the use of dental implants. We have examined 300 patients aged from 25 to 65 years who need dental treatment with partial and complete absence of teeth at the Department of IFNMU Prosthetic Dentistry. First of all, attention was paid to the patient's age (according to the WHO age group classification), gender and objective data on partial and complete absence of teeth (on the upper jaw, lower jaw or both jaws).
Clinical assessment was carried out on the basis of a collection of complaints, anamnesis of life and disease and objective data examination. The age of all patients ranged from 25 to 65 years.
Results. Based on the study of complaints and objective examination of patients, it was found that among 300 people who applied to the prosthetic dentistry clinic, 245 patients complained of the absence of one or more teeth (81.6%) and the need for prosthetic replacement of the existing dentition defect to restore chewing function and aesthetics; about 55 patients complained of complete loss of teeth in the upper or lower jaw (18.4%). Complete tooth loss in the upper jaw was diagnosed in 17 patients (30.9%) and complete tooth loss in the lower jaw – in 38 patients (69.1%). The number of patients with partial tooth loss in the frontal group was 42 patients (17.1%), in the lateral group – 203 patients (82.9%).
During the study, among the total number of patients, a predominance of female patients (70%), aged 35-44 years (28.6%) over male patients (30%), aged 35-44 years (12.3%) with partial defects of the dentition and complete absence of teeth was established. After cone-beam computed tomography, a sufficient volume of bone tissue (12-15 mm) was diagnosed mainly in female individuals (74.7%), aged 35-44 years (41.4%), who need dental implantation and prosthetic treatment.
Conclusions.
Based on the data of objective examination, clinical and special examination methods, a high level of need for prosthetic treatment with the usage of dental implants was proven. Among the total number of patients, a predominance of female individuals (70%), aged 35-44 years (28.6%) over male individuals (30%), aged 35-44 years (12.3%) with partial defects of the dentition and complete absence of teeth was established.
In the frontal area of the alveolar process, a sufficient level of bone tissue was diagnosed in 182 patients (91.9%) among women, and in the lateral area - in 178 patients (89.8%). A sufficient level of bone tissue in the frontal area was determined in 62 patients (92.5%) and in the lateral area - in 58 patients (86.5%) among male population. During the study, it was found that it was impossible to perform dental implantation at 4 patients (16,0%) of the study group due to significant bone loss and the need of bone augmentation. РЕЗЮМЕ.
Мета дослідження — вивчення потреби в ортопедичному лікуванні пацієнтів із частковою і повною відсутністю зубів із застосуванням дентальних імплантатів шляхом проведення обстеження пацієнтів, які звернулися по стоматологічну допомогу.
Матеріали та методи. У статті визначено потребу в ортопедичному лікуванні пацієнтів із частковою і повною відсутністю зубів із застосуванням дентальних імплантатів шляхом обстеження 300 пацієнтів віком від 25 до 65 років, які звернулися по стоматологічну допомогу із потребою ортопедичного лікування часткової та повної відсутності зубів на кафедру ортопедичної стоматології ІФНМУ. В першу чергу звертали увагу на вік пацієнта (за класифікацією вікових груп за ВООЗ), стать та об’єктивні дані часткової та повної відсутності зубів (на верхній щелепі, нижній щелепі чи на обох щелепах).
Клінічна оцінка проводилася на підставі збору скарг, анамнезу життя та захворювання, даних об’єктивного огляду. Серед обстежених переважали жінки (70%). Вік хворих коливався від 25 до 65 років.
Результати. На основі вивчення скарг та об’єктивного огляду пацієнтів встановлено, що серед 300 осіб, які звернулися в клініку ортопедичної стоматології, 245 пацієнтів скаржилися на відсутність одного чи декількох зубів (81,6%) та на необхідність проведення ортопедичного заміщення наявного дефекту зубного ряду для відновлення функції жування та естетики; близько 55 пацієнтів скаржились на повну втрату зубів верхньої чи нижньої щелепи (18.4%). Повну втрату зубів на верхній щелепі було діагностовано у 17 пацієнтів (30.9%), а з повною втратою зубів на нижній щелепі – 38 пацієнтів (69.1%). Кількість пацієнтів із частковою втратою зубів у фронтальній групі становила 42 пацієнти (17.1%), в боковій групі – 203 пацієнти (82.9%).
В ході проведеного дослідження серед загальної кількості пацієнтів встановлено перевагу осіб жіночої статі (70%), віком 35-44 роки (28.6%) над кількістю осіб чоловічої статі (30%), віком 35-44 роки (12.3%) із наявністю часткових дефектів зубних рядів та повної відсутності зубів. Після проведення конусно-променевої комп’ютерної томографії достатній об’м кісткової тканини (12-15 мм) було діагностовано переважно у осіб жіночої статі (74.7%), віком 35-44 роки (41.4%), яким необхідно провести дентальну імплантацію та ортопедичне лікування.
Висновки.
На основі даних об’єктивного огляду, клінічних і спеціальних методів обстеження доведено високий рівень потреби ортопедичного лікування часткової та повної відсутності зубів із застосуванням дентальних імплантатів. Серед загальної кількості пацієнтів встановлено перевагу осіб жіночої статі (70%), віком 35-44 роки (28.6%) над кількістю осіб чоловічої статі (30%), віком 35-44 роки (12.3%) із наявністю часткових дефектів зубних рядів та повної відсутності зубів.
У фронтальній ділянці альвеолярного відростка достатній об’єм кісткової тканини серед жінок було діагностовано у 182 пацієнтів (91.9%), а в боковій ділянці – у 178 пацієнтів (89.8%). У чоловіків достатній об’єм кісткової тканини у фронтальній ділянці був визначений у 62 пацієнтів (92.5%), а в боковій ділянці – у 58 пацієнтів (86.5%). При проведенні дослідження виявлено неможливість проведення дентальної імплантації в 4 осіб дослідної групи (16,0%) у зв’язку зі значною втратою кісткової тканини та необхідністю проведення кісткової аугментації.
Ключові слова: дефекти зубних рядів; повна відсутність зубів; дентальні імплантати; ортопедичне лікування; потреба в лікуванні
Poisoning with phosphorus-containing chemical warfare agents: expert case
No full textIntroduction. Poisoning with chemical warfare agents remains a relevant problem in the modern world due to the threat of chemical warfare and terrorism. Cases of poisoning in conditions of full-scale combat operations are not uncommon and require a special approach to forensic medical examination.
Main Concerns and Expert Findings. A case is presented of the death of a serviceman as a result of poisoning with a chemical substance dropped by an enemy drone. External examination revealed marked pupillary dilation and conjunctival hyperemia with multiple hemorrhages. Internal examination demonstrated a generalized hemorrhagic syndrome with damage to the respiratory, nervous, and digestive systems.
Expert Assessment. A comprehensive forensic medical examination was conducted, including forensic histological and forensic toxicological investigation. An unknown phosphorus-containing substance was detected in the organs and on a fragment of the victim's clothing.
Conclusions. Death occurred from acute poisoning with an unknown phosphorus-containing chemical substance. The case emphasizes the importance of comprehensive forensic medical investigation when poisoning with chemical warfare agents is suspected and the necessity of developing methods for identifying unknown toxic agents.Анотація. Отруєння хімічними бойовими речовинами залишається актуальною проблемою в сучасному світі через загрозу хімічної війни та тероризму. Випадки отруєнь в умовах повномасштабних бойових дій не є рідкістю і потребують особливого підходу до судово-медичної експертизи.
Основні аспекти та експертні висновки: Представлено випадок загибелі військовослужбовця внаслідок отруєння хімічною речовиною, скинутою ворожим дроном. Зовнішній огляд виявив виражене розширення зіниць та гіперемію кон'юнктиви з множинними крововиливами. Внутрішнє дослідження продемонструвало генералізований геморагічний синдром з ураженням дихальної, нервової та травної систем.
Експертна оцінка: Проведено комплексну судово-медичну експертизу, що включала судово-гістологічне та судово-токсикологічне дослідження. В органах та на фрагменті одягу потерпілого виявлено невідому фосфорвмісну речовину.
Висновки: Смерть настала від гострого отруєння невідомою фосфорвмісною хімічною речовиною. Випадок підкреслює важливість комплексного судово-медичного дослідження при підозрі на отруєння хімічними бойовими речовинами та необхідність розробки методів ідентифікації невідомих токсичних агентів.
Ключові слова: хімічні бойові речовини, фосфорвмісні сполуки, судово-медична експертиза, геморагічний синдром, судово-токсикологічна експертиза
 
Ultrastructural changes of macrophages in experimental systemic sclerosis and their modulation by vitamin D3 and α-tocopherol acetate
No full textBackground. Systemic sclerosis (SSc) is characterised by immune dysregulation, microvascular injury, and progressive fibrosis. Macrophages are increasingly recognised as key drivers of fibro‐inflammation, yet their ultrastructural responses in SSc-like conditions and the potential for micronutrient/antioxidant correction remain underexplored.
Objectives. To examine the electron-microscopic changes in macrophages in an experimentally induced SSc model and to evaluate whether vitamin D3 (VD3) plus α-tocopherol acetate (VE) mitigates macrophage injury.
Methods. Eighty-five adult Wistar rats were randomised to: intact (IG, n=15), vehicle control (CG, n=20), SSc-like induction (EG1, n=25), and induction plus corrective treatment (EG2, n=25). SSc-like changes were induced with subcutaneous 5% sodium hypochlorite (0.5 mL, three times weekly for six weeks). EG2 additionally received VD3 (1,000 IU/100 g, i.m.) and VE (10 mg/100 g, i.m.) during weeks 4-6. Electron microscopy processing, imaging, and analysis were performed in a blinded manner. At week 8, lungs were sampled under thiopental anaesthesia. Ultrastructure of alveolar macrophages was assessed by electron microscopy using standardised fixation, embedding, sectioning, and imaging protocols. The IFNMU Bioethics Committee approved all procedures.
Results. CG macrophages displayed preserved ultrastructure. EG1 showed marked injury, characterised by swollen, low-electron-density cytoplasm; severely deformed mitochondria with loss of cristae; dilated, granular endoplasmic reticulum with sparse ribosomes; and abundant lysosomes/phagosomes, consistent with oxidative and proteostatic stress. In EG2, ultrastructure improved relative to EG1. Visible nucleoli and shallow envelope indentations characterised the nuclei. Mitochondria were enlarged but structurally more coherent, and mildly dilated endoplasmic reticulum tubules were present. There were fewer lysosomes/phagosomes, indicating partial restoration of cellular organisation and a trend toward homeostatic recovery.
Conclusions. In an SSc model, alveolar macrophages undergo profound ultrastructural injury that is partially reversed by combined VD3 and VE. These data support macrophages as actionable targets and suggest that micronutrient/antioxidant modulation can attenuate immune-metabolic and oxidative stress–related damage, warranting translational studies on adjunctive strategies for systemic sclerosis (SSc)
Primary Thyroid Lymphoma: A Case Report
Full text linkIntroduction. Primary thyroid lymphoma (PTL) is a rare thyroid gland malignancy. In addition to airway compression symptoms and signs, which are the most common clinical findings, PTL may present with hypothyroidism or B symptoms of lymphoma, including night sweats, weight loss, and fever. Hashimoto thyroiditis is considered a significant risk factor and the most important underlying cause of PTL. Treatment options for PTL include chemotherapy, radiotherapy, and surgery. In this study, we present a patient who exhibited airway compression symptoms and was treated via total thyroidectomy.
Case Report. A 62-year-old woman presented with complaints of weakness and fatigue lasting for approximately four years. The thyroid gland appeared enlarged on inspection and firm on palpation. The patient was diagnosed with hypothyroidism, characterized by elevated autoimmune antibody levels. Ultrasound imaging revealed thyroid enlargement with parenchymal heterogeneity. Despite achieving euthyroidism through thyroid hormone replacement therapy, thyroid enlargement and ultrasound features persisted during follow-up, accompanied by ongoing complaints of neck pain and redness. On magnetic resonance imaging, the thyroid gland appeared markedly enlarged with abnormal superior and inferior extensions. Due to the rapid, diffuse growth of the goitre, the patient underwent bilateral total thyroidectomy. She was discharged on the first postoperative day after an uneventful recovery. In her postoperative first-week follow-up, she reported no complaints and was doing well. Following the histopathological diagnosis of B-cell marginal zone lymphoma, the patient was referred to the Department of Hematology, and a close follow-up was arranged. At her postoperative ninth-month follow-up, she remains asymptomatic and recurrence-free.
Conclusions. Thyroid lymphoma can present with rapid growth in the thyroid gland. In addition to chemotherapy and radiotherapy, surgery may be indicated in cases with symptoms and signs of airway compression