Case Study 20

What type of radiological test is described here

CT scans

What procedure will determine the diagnosis

Aspiration of tissue and pathological examination

Which of the following is not a possible diagnosis

Lesion composed of many blood vessels

Where is the mass located

Behind and to the side of the left lobe of the thyroid gland

Case Study

Radiology Report: Mass Adjacent to Thyroid, Lt side on US done 5/5/00. EXAM: NECK W/WOUT CONTRAST 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 2.2x3x1.8 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, possibly 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.