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Ultrasound of patient's neck region revealing multiple enlarged lymph nodes seen predominantly along the right side of the neck
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Context 1
... year after her initial presentation, she developed painful right lateral neck swellings that were associated with fever. Additionally, her goiter grew progressively larger. She also experienced hoarseness of voice, dyspha- gia, and dyspnea. She had significant loss of weight of 6 kg over 2 months, with normal appetite. She has had recent travel history to South Africa prior to experiencing the painful right lateral neck swellings. There was no known contact history. In addition, there was no known family history of thyroid cancer and no previous history of irra- diation of the neck. Ultrasound of neck region revealed bilateral thyroid nodules with no suspicious features, and multiple enlarged lymph nodes were detected along the right side of the neck (Fig. 1). Ultrasound-guided fine needle aspiration cytology (FNAC) of the thyroid swelling revealed PTC on histology. The FNAC of right supraclavicular lymph node showed polymorphous lymphoid cells. Computed tomography (CT) scan of the head and neck region showed bilateral thyroid nodules; the largest nodule was located in the right thyroid lobe, measuring 8 × 6 mm (Fig. 2). Also, on CT scan, there are several enlarged right supraclavicular lymph nodes with central necrosis (Fig. 2). In view of the known right PTC, the enlarged right supraclavicular lymph nodes likely represented nodal ...
Context 2
... neck swellings. There was no known contact history. In addition, there was no known family history of thyroid cancer and no previous history of irra- diation of the neck. Ultrasound of neck region revealed bilateral thyroid nodules with no suspicious features, and multiple enlarged lymph nodes were detected along the right side of the neck (Fig. 1). Ultrasound-guided fine needle aspiration cytology (FNAC) of the thyroid swelling revealed PTC on histology. The FNAC of right supraclavicular lymph node showed polymorphous lymphoid cells. Computed tomography (CT) scan of the head and neck region showed bilateral thyroid nodules; the largest nodule was located in the right thyroid ...
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Citations
Background: The papillary carcinoma thyroid is a rare disease in adolescents and children. A high level of suspicion should arouse as soon as the physician comes across swelling in neck. Appropriate management yields a good survival rate. Case history: We present a case of the papillary carcinoma thyroid in a 13-year old girl presented to outdoor of Jinnah Hospital, Lahore with painless swelling in right side of neck for three months. There were associated smaller swelling matted on palpation. No history of palpitations, fever, weight loss and family history of tuberculosis contact or cancer in family. Initial radiology and blood investigations showed an euthyroid goitre. The fine needle aspiration of lymph node only showed reactive hyperplasia. The matted lymph node was partially excised for histopathology as suspicion of tuberculosis existed due to its endemic feature. Later, it was found to be papillary carcinoma of thyroid. Total thyroidectomy was done with neck dissection followed by treatment at nuclear medicine department. Conclusion: Thyroid cancer is quite uncommon in adolescents but strong suspicion should arise when dealing with neck swelling even in this age group. Thorough history, watchful physical examination and timely investigations can save clinician from missing the diagnosis.
