Data
Clinical presentation. An 89-year-old woman presented with pneumonia. Pulmonary CT scan revealed multiple metastatic pulmonary nodules and a nodular goiter which spread substernally.
Palpation: the entire right lobe was enlarged, hard, not freely moveable. There was a similarly hard nodule in the left lobe..
Laboratory test: TSH 3.18 mIU/L.
Lesion in question:
the nodular area occupying almost the entire right lobe.