Open AccessA Diagnostic Dilemma: A Young Boy with Loss of Weight, Pulmonary Infiltrates and Cervical Lymphadenitis
Author(s) -
Asmita Mehta,
KandukuriMahesh Kumar,
Rajesh Venkitakrishnan
Publication year - 2013
Publication title -
journal of clinical and diagnostic research
Language(s) - English
Resource type - Journals
eISSN - 2249-782X
pISSN - 0973-709X
DOI - 10.7860/jcdr/2013/5756.3251
Subject(s) - medicine , medullary cavity , differential diagnosis , thyroid carcinoma , cervical lymph nodes , pathology , lymph node , thyroid , medullary carcinoma , cervical lymphadenopathy , tuberculosis , radiology , cancer , disease , metastasis
Cervical lymphadenitis is a common finding in young adults in a country like India, where tuberculosis is endemic. We are presenting the case of a young boy who presented with low grade fever, dry cough, weight loss, and a cervical swelling. His chest X-ray showed diffuse reticulonodular infiltrates. Contrast enhanced CT of chest showed bilateral multiple ring shadows. Cervical lymph node fine needle cytology suggested a metastatic thyroid carcinoma. He was evaluated extensively and a final diagnosis of a familial medullary thyroid carcinoma was made. Medullary thyroid carcinoma should be considered in the differential diagnosis of cervical lymphadenitis with lung infiltrates in young adults. It may be sporadic or a part of an inherited autosomal dominant disorder like multiple endocrine neoplasia. Genetic testing should be done for all patients with a diagnosis of medullary thyroid carcinoma.