SUN-626 Thyroid Cancer and Lymphoma: From One to Three to Two

The incidence of squamous cell carcinoma (SCC) of the Thyroid is <1% of all thyroid malignancies. A combined diagnosis of SCC or squamous metaplasia and papillary thyroid carcinoma (PTC) has only been reported in a handful of cases. It is important to identify the correct diagnosis for optimal treatment. We present a case of a 47 year old female who presented with SOB and palpitations and was found to have a thyroid nodule on CT angiogram. In addition, there were lymph nodes identified in the mediastinum. Patient had a fine-needle aspiration of the thyroid nodule that showed PTC and she underwent total thyroidectomy. However, the initial thyroid pathology was thought to show squamous cell carcinoma in addition to papillary thyroid carcinoma. With continued pursuit of patient's unique findings, she additionally underwent lymph node biopsy under thoracoscopy which was consistent with Hodgkin's lymphoma. After further evaluation, it was concluded that the patient did not have SCC of the thyroid. Patient ultimately was discharged with the diagnosis of PTC with squamous metaplasia and classic Hodgkin's lymphoma.