Sandbox:DDx HEENT
- 65 yo women
- Rapidly enlarging neck mass
- Neck pain, dyspnea, dysphagia, and hoarseness
- Constitutional symptoms
- Tender hard nodular goiter
- Extensive lymphadenopathy
- Painless thyroid nodule
- Neck lymphadenopathy
- Elevated calcitonin
- Elevated chromogranin
- Elevated CEA
- Multiple hypoechoegenic lesions on U/s
- Lymph node calcifications
- Liver metastasis
- Nested cellular pattern separated by delicate vascular septa
- Polygonal cells, round nuclie with coarse chromatin, granular cytoplasm, surrounded by amyloid deposits
- Vascular stroma with hemorrhage, edema, and coarse calcification
- C-cell hyperplasia may be present
- RET proto-oncogene