Sandbox:DDx HEENT: Difference between revisions

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* 65 yo women
* 40-60 yo women
* Rapidly enlarging neck mass
* Weight loss, heat intolerance, diarrhea, insomnia, hair loss and palpitations 
* Neck pain, dyspnea, dysphagia, and hoarseness
* Ophthalmopathy and
* Constitutional symptoms


* Tender hard nodular goiter
* Diffusely enlarged, symmetric, nontender goiter
* Extensive lymphadenopathy
* Lid lag and exophthalmus
* Pretibial myxedema
* Moist warm skin
 
* Decreased TSH
* Elevated T3 and T4
* Positive TSH-receptor antibodies
 
* Plump follicular cells with eosinophilic cytoplasm
* Hyperplastic follicles with papillary epithelial infoldings
* Colloid 'scalloping' at the apical membrane


* Pleomorphic giant cells
* Connective tissue septae
* Necrosis and vascular invasion
* Increased mitotic activity
* Rhabdoid inclusions
* Well-differentiated cells palisading at necrotic edges


* BRAF gene mutation
* BRAF gene mutation
* p53 gene mutation
* p53 gene mutation

Revision as of 20:19, 1 November 2015

  • 40-60 yo women
  • Weight loss, heat intolerance, diarrhea, insomnia, hair loss and palpitations
  • Ophthalmopathy and
  • Diffusely enlarged, symmetric, nontender goiter
  • Lid lag and exophthalmus
  • Pretibial myxedema
  • Moist warm skin
  • Decreased TSH
  • Elevated T3 and T4
  • Positive TSH-receptor antibodies
  • Plump follicular cells with eosinophilic cytoplasm
  • Hyperplastic follicles with papillary epithelial infoldings
  • Colloid 'scalloping' at the apical membrane


  • BRAF gene mutation
  • p53 gene mutation
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