Purpose: To present an unusual case of a mediastinal and cervical lymphoma infiltrating the thyroid gland mimicking thyroid cancer.
Methods: Data was collected from patient’s medical records and imaging studies including: computed tomography, ultrasound and PET.
Results: A 79 year old male presented with an acute onset of dyspnea. The patient underwent chest X ray that revealed enlargement of the mediastinum. Subsequently, a neck ultrasound was performed, that demonstrated a mediastinal mass infiltrating the thyroid gland and cervical pathological lymphadenopathy. Following, he underwent a chest CTA, which further demonstrated a lower neck mass continuous with the superior mediastinum, surrounding the anterior and lateral aspects of the trachea with no separation plane from the thyroid gland. Similarly to the ultrasound exam, multiple pathological cervical lymph nodes were demonstrated.
Lastly, an urgent FNB from a cervical lymph node was performed under ultrasound guidance and a diagnosis was concluded.
A discussion of the differential diagnosis of anterior mediastinal mass and infiltrating thyroid masses will take place.
Conclusions: Anterior mediastinal masses might be caused by a myriad of pathologies, thyroid masses being amongst the most common. Infiltrating thyroid masses might represent a primary thyroid pathology or an external mass infiltrating the gland.
