Sandbox:DDx HEENT

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  • 45-50 yo women
  • Neck tightness
  • Dyspnea, dysphagia, and hoarseness
  • Gradual onset of wood-hard, painless, fixed goiter
  • Lymphadenopathy is absent
  • Elevated ESR
  • Elevated IgG4
  • Normal T3, T4, and TSH
  • Homogeneously hypochoic
  • Diffuse borders of the gland
  • Decreased iodine uptake on thyroid scan
  • Broad bands of fibrosis
  • Lymphohistiocytic infiltrate
  • Not applicable
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