Chapter Twenty
PRACTICAL APPLICATIONS
Name: ______________________________
A. Radiology Report
Mass Adjacent to Thyroid—Lt side on US done 5/5/10
EXAM: NECK W/WOUT CONTRAST
5/9/10
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 × 1.8 cm 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.
1. What type of radiologic test is
described here? ……………………………..
A. Ultrasound
B. CT scans
C. Pyelogram
D. PET scan
2. Where is the mass located? ……………..
A. Within the left lobe of the thyroid gland
B. Between the left and right carotid arteries
C. Behind and to the side of the left lobe of
the thyroid gland
D. In front and to the side of the thyroid
gland
3. Which of the following is not a
possible diagnosis? ………………………..
A. An unusual mass on the thyroid gland
B. Lymphadenopathy
C. Tumor mass adjacent to the thyroid gland
D. Lesion composed of many blood vessels
4. What procedure will help determine
the diagnosis? ………………………………
A. Aspiration of tissue and pathologic
examination
B. Removal of the thyroid gland
C. Removal of thyroid tissue for biopsy
D. Further scans with ultrasound guidance