PMC7519239_01
Huge soft tissue mass, more on the right side indistinguishable from the thyroid gland displacing the trachea and esophagus to the left. Mutliple matted nodes underneath the sternoleidomastoid bilaterally.
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Numerous matted lymph nodes were noted beneath the sternocleidomastoid muscles on both sides, extending to the posterior triangles of the neck (Fig. 1).
Lateral view of the neck demonstrating preoperative bulging of the tumor.
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The patient underwent preoperative risk assessment and was eventually scheduled for surgery (Fig. 2).
images of the intraoperative appearance of the thyroid lobes upon excision of the right thyroid lobe (right) and of the left thyroid lobe (left).
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The isthmus was enlarged to 6 x 4 cm, with the left thyroid lobe measuring 5 x 4 cm (Fig. 3).
Follicles with diffuse infiltration by large atypical lymphoid cells (H&E, x40).
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Immunohistochemical staining was positive for CD 45+ and CD 20+, confirming the diagnosis (Fig. 4, Fig. 5, Fig. 6).
Malignant cells diffusely immunoreactive to CD 20 (x40).
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Immunohistochemical staining was positive for CD 45+ and CD 20+, confirming the diagnosis (Fig. 4, Fig. 5, Fig. 6).