A 64-year-old woman presented with a multinodular goiter. Cervical ultrasonography showed multiple nodules throughout the thyroid. Fine-needle aspiration and a core biopsy were perfomed. The fine-needle aspirate revealed a small clonal population of κ light-chain–restricted B cells. Although not diagnostic, this finding was suggestive of a lymphoproliferative process. Positron emission tomography–computed tomography demonstrated diffuse uptake throughout the thyroid, without evidence of lymphadenopathy or distant metastases. A bone marrow biopsy specimen showed normal cellular marrow. A right thyroid nodule was excised for diagnostic purposes. Pathologic examination revealed Hashimoto thyroiditis, without evidence of lymphoma.
Fraser SC, Bishop JA, Champaneri S, Tufano RP. Pathology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2010;136(6):635. doi:10.1001/archoto.2010.67-a