Sandbox:DDx HEENT: Difference between revisions

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* 45-50 yo women  
* 35-50 yo women
* Neck tightness
* Painless nodular enlargement in the neck
* Dyspnea, dysphagia, and hoarseness
* Euthyroid state


* Gradual onset of wood-hard, painless, fixed goiter
* Iso-hyperechoic mass with alarge cystic component on U/S
* Lymphadenopathy is absent
* Surrounding hypoechoic halo
* Spongelike/honeycomb pattern with eggshell coarse calcifications
* Intranodular vascularity


* Elevated ESR
* Heterogeneous iodine uptake on thyroid scan
* Elevated IgG4
* Normal T3, T4, and TSH


* Homogeneously hypochoic
* Follicles of variable size
* Diffuse borders of the gland
* microfollicular architecture
* Decreased iodine uptake on thyroid scan
* Unencapsulated 
* No nuclear features suggestive of malignancy


* Broad bands of fibrosis
* TG-gene
* Lymphohistiocytic infiltrate 
* TPO-gene
 
* SLC5A5 gene
* Not applicable
* SLC26A4 gene
* TSH-R-gene
* DEHAL-1 gene
* DUOX2 gene

Revision as of 22:31, 1 November 2015

  • 35-50 yo women
  • Painless nodular enlargement in the neck
  • Euthyroid state
  • Iso-hyperechoic mass with alarge cystic component on U/S
  • Surrounding hypoechoic halo
  • Spongelike/honeycomb pattern with eggshell coarse calcifications
  • Intranodular vascularity
  • Heterogeneous iodine uptake on thyroid scan
  • Follicles of variable size
  • microfollicular architecture
  • Unencapsulated
  • No nuclear features suggestive of malignancy
  • TG-gene
  • TPO-gene
  • SLC5A5 gene
  • SLC26A4 gene
  • TSH-R-gene
  • DEHAL-1 gene
  • DUOX2 gene
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