Clinical data: a 43-year-old woman was referred for an evaluation of difficulties in swallowing.

Palpation: the right thyroid was enlarged and a hard nodule was palpable in the upper pole. Enlarged, firm lymph nodes were also palpable in the right submandibular area.

Functional state: euthyroidism (TSH-level 0.58 mIU/L).

Ultrasonography: there was a hypoechogenic nodule in the left lobe. Multiple enlarged lymph nodes were present all along the left side of the neck.

Cytology: the lymph node and the thyroid yielded similar report: suspicion of Hodgkin's disease

Histopathology: Hodgkin's disease of mixed cellular type.