Sandbox:DDx HEENT

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  • Childhood
  • Painless, rounded, anterior midline neck swelling
  • May have difficulty breathing or dysphagia
  • Smooth, cystic, and fluctuant neck lump
  • Elevates on tongue protrusion
  • Normal T3, T4, and TSH
  • Thin walled, smooth, well defined homogeneously attenuating mass
  • Within 2cm of the midlines
  • Light rim of enhancement
  • Sternocleidomastoid muscle displaced posterolaterally


  • Colloid, neutrophils, lymphocytes, macrophages, and ciliated columnar cells on FNA
  • Variable epithelial lining, thyroid follicles, mucous glands, lymphocytic infiltration, granulation tissu, and fibrosis on FNA
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