Metastatic papillary carcinoma of the thyroid to  parietal pleura

Patient is 29 year old Indian gentleman. He had a history of RTA with blunt trauma to the chest

He was brought to A/E with difficulty in breathing.

Plain x-ray chest showed (for x-ray click here) -

    massive left sided pleural effusion with mediastinal shift to the right side.

Procedure: Drainage of pleural fluid was performed. Post drainage   chest x-ray

Cytology study: Few suspicious cells

CT scan chest: Thickened left pleura especially at the lower cuts. Image 1, 2, 3, 4

Biopsy: taken from pleura lower cuts.

Histopathology: Metastatic papillary carcinoma of the thyroid to the left parietal pleura

USS Thyroid: a nodule 3 mm in the right lobe and 3 nodules -each 1 mm in diameter- in the right lobe of the thyroid.

    image 1, image 2, Image 3

Clinical Re-examination of the neck: for lymph nodes revealed lymphadenopthy of the upper and lower deep cervical groups. They were enlarged moderate in size, not tender and more on the left side.

Referral : Patient was referred to radiotherapist for radioactive iodine therapy.