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QJM Advance Access originally published online on June 14, 2006
QJM 2006 99(7):487; doi:10.1093/qjmed/hcl060
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© The Author 2006. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Clinical picture

‘Ebony and ivory’ thyroid carcinoma

Dr. N. Mumoli, Dr. M. Cei and Dr. M.S. Verzuri

Department of Internal Medicine, Ospedale Civile, Livorno, Italy.

email: nimumoli{at}tiscali.it

Formula

An 80-year-old woman underwent ultrasound and Doppler examination of the neck vessels because of a stroke. Two adjacent nodules of solid appearance were discovered in the right lobe of the thyroid gland as an incidental finding. Both nodules were oval, about 7 mm in length, and isoechoic with the surrounding thyroid tissue. The lateral one (white arrow) had an hyperechoic border with posterior shadowing, (a finding indicating calcification) and the medial one (black arrow) had an hypoechoic halo, with a weak posterior reinforcement of the ultrasound (suggesting perilesional oedema). Subsequent scanning revealed neither left lobe lesions nor lymph node enlargement. Fine-needle aspiration biopsy yielded positive results in both cases. Cytology was suggestive of papillary carcinoma for the lateral node, and a follicular variant of papillary carcinoma for the medial node. The patient was discharged 7 days later, having refused surgical consultation. Collision tumours are a well known phenomenon in thyroid tissue, and mixed medullary-follicular thyroid carcinomas are usually described. Fine-needle aspiration has become the primary diagnostic tool in the initial evaluation of thyroid nodules, but as the patient refused surgery, definitive histological diagnosis was not possible.


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This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
99/7/487    most recent
hcl060v2
hcl060v1
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Right arrow Articles by Mumoli, N.
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