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ACNM Spotlights May 2017 Case

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Anamnèse

A 36 year-old lady presented with palpitations, sweating, and hypertension.


Résultats

Lab Findings: TSH 0.05,  T4: 12.5 .   A thyroid scan and uptake scan were (Image 1): 2 hr uptake: 20% (Normal = 5-15%), 24 hr uptake: 40% (Normal = 15-35%) . The patient was then treated with 10 mCi I-131.  The patient returned 4 months later with significant improvement of symptoms, TSH 2.5,  T4 11,  Thyroid uptake and scan (image 2): 2 hr uptake: 8%, 24 hr uptake: 20%.

 

What is the most likely diagnosis for the finding in Image 1?


Diagnostic

ACNM Spotlights May 2017 Case


Discussion

Autonomous Nodule: Plummer's disease. The function of rest of the gland is suppressed due to TSH suppression by feedback mechanism.


DDx

Graves disease vs toxic goiter.


Références

Ultrasound: A solitary nodule in inferior pole of left lobe. Thyroid scan: A solitary functioning nodule with no function in the rest of gland. Post-therapy: The nodule showed no function, and the gland showed uniform uptake.



ACNM Spotlights May 2017 Case Image 1

Image 1

ACNM Spotlights May 2017 Case Image 2

Image 2

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