Sandbox:DDx HEENT

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  • 30-50 yo Caucasian women
  • Ionizing radiation exposure
  • Positive family history
  • Asymptomatic painless neck nodule


  • Elevated thyroglobulin level
  • HBME-1 stain +ve and ATP5E stain +ve


  • Orphan Annie eye and Psammoma bodies
  • Unencapsulated multifocal tumor lesions
  • Positive lymphatic spread


  • Solitary mass with irregular borders and increased vascularity on U/S
  • Located at the subcapsular region
  • Small punctate regions of echogenicity due to calcification
  • Lymph node metastases present
  • RAS oncogene activation
  • PAX8-PPAR gamma 1 genes rearrangement
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