PMC5199157_01
Cervical ultrasound: sub sternal goiter with heterogeneous echo structure. No enlarged lymph nodes.
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The cervical ultrasound (Fig. 1) revealed an enlarged thyroid gland with heterogeneous echo structure, revealing a nodular lesion occupying almost the entire left lobe, migrating to the mediastinum, correlated with a substernal goiter.
Histological findings. A - Assymetrical thyroid gland, with a multinodular, whitish cut surface; B - Diffuse infiltration by large atypical lymphoid cells (H&E, x40); C - Round-to-oval cells with high nuclear/cytoplasmic ratio, coarse chromatin and numerous mitoses (H&E, x400); D - Malignant cells diffusely immunoreactive to CD 20 (x40).
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The histological examination (Fig. 2) revealed partial effacement of the thyroid parenchymal architecture by a population of round-to-oval lymphoid cells, with large and pleomorphic nuclei, coarse nuclear chromatin, visible nucleoli and scarse eosinophilic cytoplasm.