EURORAD ESR

Case 13931

Papillary carcinoma of thyroid. US and MRI features of U5 rare malignant variant thyroid cancer

Author(s)
Fahad Mewazy Al-Hamidi, Aikaterini Ntoulia, Mark Owen

Withybush General Hospital,
Hywel Dda Health Board,
Radiology;
Email: Fahad.Mewazy@wales.nhs.uk
 
Patient
female, 29 year(s)
 
 
  • Figure 1
    Ultrasound
     

    Grey scale transverse US view reveals diffuse enlargement of the right thyroid lobe with hypoechoic echotexture and multiple fine microcalcifications.

     
    Area of Interest: Head and neck; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Colour Doppler application shows increased internal vascularity at the periphery of the lesion.

     
    Area of Interest: Head and neck; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Grey scale US image illustrates pathologically enlarged lymph node with loss of normal central fatty hilum and increased reflectivity simillar to the primary thyroid lesion adjacent to the major blood vessels.

     
    Area of Interest: Head and neck; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Colour Doppler interrogation demonstrates profuse internal vascularity within the metastatic node.

     
    Area of Interest: Head and neck; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Grey scale US image shows another smaller metastatic lymph node with simillar hyperechoic echotexture.

     
    Area of Interest: Head and neck; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Colour Doppler US image displays marked internal vascularity within another metastatic lymph node.

     
    Area of Interest: Head and neck; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 2
    MRI
     

    T2-weighted sequence confirms heterogeneous enlargement of the right thyroid lobe that extends into the right retropharyngeal space.

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Axial T1-weighted sequence reveals the right thyroid lesion encroaching upon longus colli muscle (arrow) and the oesophagus (arrowhead). However, the fat planes are intact with no evidence of invasion.

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Axial T1-FS post gadolinium. The right thyroid lobe (asterisk) is diffusely enlarged compared to the left. Both thyroid lobes and ipsilateral level III cervical nodes (arrowhead) display similar intense enhancement.

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Axial T1-FS post gadolinium administration at a lower level reveals the presence of a pathologically enlarged lymph node at level IV with similar enhancement pattern to tissue in the right retropharyngeal space.

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    STIR coronal image delineates the exact extension of cervical lymphadenopathy (arrows) along the right internal jugular vein chain adjacent to the right thyroid lobe lesion (asterisk) at levels III and IV.

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
Grey scale transverse US view reveals diffuse enlargement of the right thyroid lobe with hypoechoic echotexture and multiple fine microcalcifications.
 
Colour Doppler application shows increased internal vascularity at the periphery of the lesion.
 
Grey scale US image illustrates pathologically enlarged lymph node with loss of normal central fatty hilum and increased reflectivity simillar to the primary thyroid lesion adjacent to the major blood vessels.
 
Colour Doppler interrogation demonstrates profuse internal vascularity within the metastatic node.
 
Grey scale US image shows another smaller metastatic lymph node with simillar hyperechoic echotexture.
 
Colour Doppler US image displays marked internal vascularity within another metastatic lymph node.
 
T2-weighted sequence confirms heterogeneous enlargement of the right thyroid lobe that extends into the right retropharyngeal space.
 
Axial T1-weighted sequence reveals the right thyroid lesion encroaching upon longus colli muscle (arrow) and the oesophagus (arrowhead). However, the fat planes are intact with no evidence of invasion.
 
Axial T1-FS post gadolinium. The right thyroid lobe (asterisk) is diffusely enlarged compared to the left. Both thyroid lobes and ipsilateral level III cervical nodes (arrowhead) display similar intense enhancement.
 
Axial T1-FS post gadolinium administration at a lower level reveals the presence of a pathologically enlarged lymph node at level IV with similar enhancement pattern to tissue in the right retropharyngeal space.
 
STIR coronal image delineates the exact extension of cervical lymphadenopathy (arrows) along the right internal jugular vein chain adjacent to the right thyroid lobe lesion (asterisk) at levels III and IV.
 
 
 
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