Sandbox:DDx HEENT
- 40-60 yo women
- Weight loss, heat intolerance, diarrhea, insomnia, hair loss and palpitations
- Ophthalmopathy
- Diffusely enlarged, symmetric, nontender goiter
- Lid lag and exophthalmus
- Pretibial myxedema
- Moist warm skin
- Decreased TSH
- Elevated T3 and T4
- Positive anti-TSH receptor antibodies
- Enlarged hyperechoic thyroid on U/S
- Abscence of nodularity
- homogeneously increased iodine uptake
- Plump follicular cells with eosinophilic cytoplasm
- Hyperplastic follicles with papillary epithelial infoldings
- Colloid 'scalloping' at the apical membrane