ULTRASOUND COURSE

47th Annual Meeting of the European Thyroid Association

Precourse activity - Case studies


Case 11 (conp011) - Lymph nodes in the neck

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Data

Clinical presentation: A 35-year-old woman has been undergone on total thyroidectomy. Histopathology disclosed a T2N1 papillary cancer in the left lobe. Radioiodine therapy was planned. The patient visited us to get information about the prognosis of her disease.

Palpation: no abnormality.

Ultrasonography: There was no parenchyma in the thyroid beds. There were multiple enlarged lymph nodes in the lateral side of the neck. One of them very close to the thyroid seemed to be benign, reactive, but there was a chain of atypical, suspicious lymph nodes next to the strernocleidomastoid muscle, these nodes presented almost all possible signs of a very suspicious lymph node; they had less hypoechoic tissue, microcalcifications, tiny cystic areas and abnormal vascular pattern but lacked hilum.

Cytology of the suspicious lymph nodes: papillary cancer.

The patient was reoperated. Histopathology disclosed metastatic foci in the lymph nodes. 6 weeks later she underwent radioiodine treatment.

 

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