Head and neck tumours: lymphoma in Hashimoto thyroiditis: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Head and neck tumours: lymphoma in Hashimoto thyroiditis

Sample item

A 45-year-old woman with long-standing Hashimoto thyroiditis notices that one lobe of her goitre has enlarged rapidly over weeks, with hoarseness and dysphagia. Which complication is most likely?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Primary thyroid lymphoma

Hashimoto thyroiditis carries a markedly increased risk of primary thyroid lymphoma, usually B-cell, which presents as rapid enlargement of a long-standing goitre with compressive symptoms. Core biopsy with flow cytometry is needed, and treatment is chemoradiotherapy.

Option by option

  • A. Medullary carcinoma

    Medullary carcinoma arises from C cells, has raised calcitonin and is unrelated to autoimmune thyroiditis.

  • B. Subacute thyroiditis

    Subacute thyroiditis is painful, self-limiting and does not enlarge rapidly with compression.

  • C. Primary thyroid lymphoma (correct)

    Correct. Rapid growth of a Hashimoto goitre with compressive symptoms suggests primary thyroid lymphoma.

  • D. Riedel thyroiditis

    Riedel thyroiditis gives a stony hard goitre with a slow course.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is C, Primary thyroid lymphoma. Hashimoto thyroiditis carries a markedly increased risk of primary thyroid lymphoma, usually B-cell, which presents as rapid enlargement of a long-standing goitre with compressive symptoms.

Why is "Medullary carcinoma" not the answer?

Medullary carcinoma arises from C cells, has raised calcitonin and is unrelated to autoimmune thyroiditis.

Why is "Subacute thyroiditis" not the answer?

Subacute thyroiditis is painful, self-limiting and does not enlarge rapidly with compression.

Why is "Riedel thyroiditis" not the answer?

Riedel thyroiditis gives a stony hard goitre with a slow course.

What concept does this question test?

It tests Head and neck tumours: lymphoma in Hashimoto thyroiditis in ENT. Core biopsy with flow cytometry is needed, and treatment is chemoradiotherapy.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Head and neck tumours: lymphoma in Hashimoto thyroiditis?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.