Extract

A 34-yr-old female presented with an incidentally detected thyroid mass. Physical examination showed a unilateral firm mass in the left neck. Ultrasound demonstrated a 2.3-cm ill-defined hypoechoic mass with internal microcalcifications at the lower pole of the left thyroid gland (Fig. 1) with cervical lymphadenopathy on the ipsilateral side. The lower pole of the right thyroid gland revealed punctate microcalcifications without discernible mass on ultrasound (Fig. 1). Fine-needle aspiration biopsy of the thyroid mass and lymph node revealed papillary carcinoma with lymph node metastasis. Subsequent total thyroidectomy with unilateral neck dissection was performed. After that, specimen radiography was done to evaluate the extent of calcifications using the Lorad/Hologic Selenia FFDM system (Lorad/Hologic, Danbury, CT) dedicated to mammography. The specimen radiograph showed diffuse scattered microcalcifications involving nearly the entire thyroid and central lymph nodes (Fig. 1). Pathological diagnosis was diffuse sclerosing variant of papillary carcinoma (DSVPC) with lymph node metastases (Fig. 2). The pathological extent of lesions was well correlated with the specimen radiograph.

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