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Thread: neck swelling

  1. #1
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    Question neck swelling

    a 60 yr old female came 2 opd with chief complaint of swelling in midle of neck
    moving with deglutition on examination. its present in pyramidal lobe region of thyroid,firm.she has normal t3 t4.she is not 4rm iodine deficient area nor she is using non iodised salt.vat could b the probable diag

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    d/d

    metastatic deposit
    a cold nodule
    Tb. lymphadenitis
    http://www.medicalgeek.com/image.php?type=sigpic&userid=6672&dateline=1196547  885

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    from where metastatic deposit can come.with normal t3 t4 cant b possible 2 hav subclinical hypo r hyperthyroidism??
    Last edited by bhavana.g; 12-05-2007 at 09:45 PM.

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    I think its thyroid adenoma.!

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    k i provide som investigation results of hers she has sub clinical hypothyroidism vith thyroid antibodies positive

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    This is Hashimoto's thyroiditis !!! Correct me if i'm wrong !!!

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    i agree vt amal. it may be hasihomotos thyroiditis

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    its hashimoto thyroiditis.fnac confirmed it with lots of lyphoid infiltration .later stage of it is atrophic thyroiditis r it can gointo thyoid lyphoma which is a very bad prognostic featur.its not vry neccesary 2 present with inflamatory feature of pain rarely it does so, then it is difficult 2 differentiate 4rm sub acute thyroiditis(viral origin mumps paramyxovirus).management by thyroxine supplementation.

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    Quote Originally Posted by bhavana.g View Post
    its hashimoto thyroiditis.fnac confirmed it with lots of lyphoid infiltration .later stage of it is atrophic thyroiditis r it can gointo thyoid lyphoma which is a very bad prognostic featur.its not vry neccesary 2 present with inflamatory feature of pain rarely it does so, then it is difficult 2 differentiate 4rm sub acute thyroiditis(viral origin mumps paramyxovirus).management by thyroxine supplementation.

    In Hashimoto's TSH-elevated,T3 &T4-decreased with presence antithyroglobulin antibodies,antimicrosomal antibodies in high titres. Initially there will be transient Hyperthyroidism then hypothyroidism. Lymphoid infiltration alone can't substantiate the diagnosis of Hashimoto's bcoz subacute lyphocytic thyroiditis(post partum thyroiditis) shows lymphoid infiltration, low titre of antibodies may also be present...but t4 &t3 are elevated.

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    dear,assassins see my above posts i mentoined in them regarding normal t3 t4 n raised tsh antithyroid antibodies +ve,thyroid swelling with no systemic features, in the 60yrs old female with fnac of lymphoid infiltration could most probably d her as hashimoto thyroiditis

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