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Cystic degeneration in a thyroid colloid nodule

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Neck swelling.

Patient Data

Age: 40 years
Gender: Female

Within the left visceral space and there is a large relatively homogeneous, well-circumscribed lesion. It is of higher density than simple fluid measuring 57 HU. There is a rim of enhancing thyroid tissue in keeping with an intraparenchymal lesion. There is positive mass effect with deviation of the trachea to the right. No airway compression seen. 

Conclusion: Large left thyroid lesion likely represents a colloid cyst with resultant mass-effect and tracheal deviation to the right.

Case Discussion

The patient went on to have the cyst aspirated.

Histology

MACROSCOPIC DESCRIPTION: 15ml clear orange fluid.

MICROSCOPIC DESCRIPTION: The smears contain scattered groups of follicular cells, abundant macrophages, colloid and acellular debris. No malignant features are identified.

FINAL DIAGNOSIS: Cystic degeneration in a colloid nodule (benign). 

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