Differential Diagnosis for a 32 y.o Woman with a Right Neck Lump and Normal Follicular Thyroid Cells on Histopathology
- Single most likely diagnosis:
- Ectopic thyroid: This is the most likely diagnosis given the presence of normal follicular thyroid cells in a cervical lymph node. Ectopic thyroid tissue can be found in various locations, including the neck, and can be mistaken for a metastatic thyroid cancer.
- Other Likely diagnoses:
- Papillary thyroid cancer (Follicular variants; 40%): Although the histopathology report shows normal follicular thyroid cells, it's possible that the sample missed the malignant cells. Papillary thyroid cancer can have a follicular variant, and metastasis to cervical lymph nodes is common.
- Follicular thyroid cancer: Similar to papillary thyroid cancer, follicular thyroid cancer can also metastasize to cervical lymph nodes. However, the presence of normal follicular cells on histopathology makes this diagnosis less likely.
- Do Not Miss diagnoses:
- Metastatic thyroid cancer (any type): It's crucial to rule out metastatic thyroid cancer, as it can have significant implications for treatment and prognosis. Although the histopathology report shows normal cells, further evaluation, such as imaging studies and additional biopsies, may be necessary to confirm the diagnosis.
- Rare diagnoses:
- Thyroglossal cyst: This is a rare diagnosis, as thyroglossal duct cysts typically present in the midline of the neck and are often associated with thyroid abnormalities. However, it's possible for a thyroglossal cyst to be located laterally and contain normal thyroid tissue.