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: The presence of normal follicular thyroid cells in a cervical lymph node, with a normal thyroid gland, suggests the possibility of ectopic thyroid tissue. This condition, although rare, can present as a neck lump and is consistent with the histopathology findings.
- Other Likely diagnoses:
- Papillary thyroid cancer: Although the histopathology report mentions normal follicular thyroid cells, papillary thyroid cancer can sometimes present with normal-appearing cells, especially if the sample is limited. Metastasis to a cervical lymph node from a primary thyroid cancer is a possibility, even if the primary site appears normal.
- Follicular thyroid cancer: Similar to papillary thyroid cancer, follicular thyroid cancer could potentially metastasize to a lymph node and present with a neck lump. However, the presence of "normal" follicular cells makes this less likely unless the cancer is well-differentiated.
- Do Not Miss diagnoses:
- Metastatic disease from another primary site: It's crucial not to miss the possibility of metastasis from another primary cancer site that could mimic thyroid tissue or present with similar histological features. This would be a critical diagnosis to consider due to its implications for treatment and prognosis.
- Rare diagnoses:
- Thyroglossal duct cyst with ectopic thyroid tissue: While thyroglossal duct cysts are more commonly associated with the midline of the neck, it's theoretically possible for ectopic thyroid tissue to be present within such a cyst, even in an unusual location like the lateral neck. However, this would be an uncommon presentation.