In: Nursing
Mass Adjacent to Thyroid—Lt side on US done 5/5/10
EXAM: NECK W/WOUT CONTRAST
4/9/20
Initially scans were obtained throughout the neck without IV contrast. Following this, a bolus of IV contrast was given and rapid scans obtained through the region of interest in the neck, related to the left lobe of the thyroid. As demonstrated on the recent ultrasound, there is a well-defined oblong mass in the left neck measuring 2.2 × 3 × 1.8cm in size. This lies posterolateral to the left thyroid lobe and is predominantly between the left common carotid artery, which is displaced posteromedially, and the left internal jugular vein, which is displaced laterally. No other adenopathy, and the remainder of the thyroid appears unremarkable.
IMPRESSION: The mass appears to be extrinsic to the thyroid, possible even within the carotid sheath. The lesion appears to be relatively avascular. The differential diagnosis would include an unusually enlarged lymph node, a very atypical thyroid nodule, or a soft tissue tumor. The lesion is very easily accessible to needle biopsy and this would certainly be the easiest method of obtaining positive confirmation. This could be done using US guidance.
The pt underwent a bone scan, which revealed irregular foci of tracer in lower T spine (T11-T12) consistent with compression fracture. There was also increased tracer in the posterior/lateral right ribs. On physical test she was diffusely tender and in pain throughout her chest/ribs and spine. The pt also underwent chest CT, which demonstrated extensive parenchymal and pleural disease encasing the entire chest and involving vessels and bronchi. Her adrenals and liver, vertebral bodies, and R scapula were also involved with metastatic disease.
A. COMPREHENSION OF TERMS
RADIOLOGY REPORT
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