Sandbox:DDx HEENT

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40-60 yo women


Painless thyroid 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
  • Lytic bone lesions or multiple lung masses due to hematogenous spread
  • Rare lymph node metastases
  • RAS oncogene activation
  • PAX8-PPAR gamma 1 genes rearrangement
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