Syncytial variant of nodular sclerosing Hodgkin's disease presenting as a thyroid nodule. A case report

The fine needle aspiration cytology of a thyroid nodule in a 19-year-old female showed Reed-Sternberg (RS) cell variants in clusters, thereby suggesting the possibility of syncytial variant of nodular sclerosing Hodgkin's disease (NSHD). A similar picture was observed on imprint smears of an excised cervical lymph node, the histology of which confirmed the original diagnosis. Following chemotherapy, the nodule disappeared. The patient was spared major thyroid surgery. It is important to recognize the rare morphologic variants and unusual clinical presentations of common diseases in order to perform appropriate studies that will ensure that the patient receives the best clinical management. Morphologic clues that should arouse the cytopathologist's awareness of this rare variant of NSHD are presented.