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Hodgkin's Disease Presenting as a Solitary Thyroid Nodule

HARDOFF, RUTH, M.D., D.Sc.*; BAR-SHALOM, RACHEL, M.D.; DHARAN, MURALEE, M.D., M.I.A.C.; LUBOSHITSKY, RAFAEL, M.D.§

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Two patients with unusual Hodgkin's disease who initially had a painless, solitary, thyroid cold nodule are described. Fine-needle aspiration revealed lymphocytic thyroiditis in one patient and a diagnosis of Hodgkin's disease was made 1 year later. In the second patient, aspiration of the nodule demonstrated a syncytial variant of nodular sclerosis Hodgkin's disease. Both patients underwent radiologic work-up, and surgery of the thyroid was avoided. After chemotherapy, both thyroid nodules disappeared. Thyroid involvement by Hodgkin's disease may be more common than anticipated, and may present atypically as a solitary thyroid nodule. Lymphocytic thyroiditis may accompany the disease and may cause a delay in the diagnosis. Recognition of this entity and the use of fine-needle aspiration may prevent unnecessary thyroid surgery, thus maintaining intact thyroid function after therapy.

*Department of Nuclear Medicine, Carmel Medical Center, Central Emek Hospital, Afula, and the Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel

Department of Rambam Medical Center, Central Emek Hospital, Afula, and the Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel

Department of Haifa, the Institutes of Pathology, Central Emek Hospital, Afula, and the Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel

§Department of Endocrinology, Central Emek Hospital, Afula, and the Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel

© Lippincott-Raven Publishers.