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This case proved to be the lymphoplasmacytoid variant of medullary
carcinoma. The cytological pattern highly resembles a lymphoid
population. On high power field several polygonal cells were found.
Nevertheless, this pattern itself may be more probable arising from a
lymphoid disorder than from a medullary carcinoma.
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Right lobe
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Lateral to the right thyroid
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The thyroid was composed of large hypoechogenic nodules. There was a
metastatic focus lateral to the thyroid. The tumor did not presented
the characteristic hyperechogenic patches.
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Taking the cytological and sonographic
pattern into account, a small cell tumor (i.e. malignant lymphoma) and
a medullary carcinoma had to be considered. Serum calcitonin
determination was performed and resulted in an elevated level.
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