<prompt> Needle biopsy of solitary thyroid nodule in a young woman with palpable cervical lymph nodes on the same sides demonstrates amyloid in stroma of lesion. Likely diagnosis isMedullary carcinoma thyroidFollicular carcinoma thyroidThyroid adenomaMulti nodular goitre  <response>: Answer is A Medullary Carcinoma thyroid Presence of thyroid nodule along with palpable cervical lymph nodes and amyloid histologically is clearly indicative of Medullary variety of Carcinoma Thyroid. Medullary Carcinoma thyroid : It is a neuroendocrine carcinoma rising from parafollicular C cells of thyroid Parafollicular C cells are derived from neural crest and secrete calcitonin. Medullary carcinoma should be suspected whenever : a. High level of serum calcitoninQ are discovered b. Cervical lymph node are discovered at time of presentation. Q - Involvement of lymph nodes occurs early.Q - Thyroid and blood born metastasis occurs early.Q c. DiarrheaQ is a presentation d. AmyloidQ is present in stroma histologically. e. MEN setting : Evidence of Pheochromocytoma Hyperparathyroidism Thyroid cancer in family. Discovery of medullary carcinoma thyroid makes family surveillance advisable.ef Hypocalcemia is associated: These cancers are associated with HypocalcemiaQ because calcitonin is secreted. Medullary carcinoma thyroid is seen as ? Sporadic : 80 Familial : 20 - Non MEN setting MEN II a MEN II b 