Hodgkin's disease presenting as a solitary thyroid nodule

Two patients with unusual Hodgkin's disease who initially had a painless, solitary, thyroid cold nodule are described. Fine-needle aspiration revealed lymphocytic thyroiditis in one patient and a diagnosis of Hodgkin's disease was made 1 year later. In the second patient, aspiration of the nodule demonstrated a syncytial variant of nodular sclerosis Hodgkin's disease. Both patients underwent radiologic work-up, and surgery of the thyroid was avoided. After chemotherapy, both thyroid nodules disappeared. Thyroid involvement by Hodgkin's disease may be more common than anticipated, and may present atypically as a solitary thyroid nodule. Lymphocytic thyroiditis may accompany the disease and may cause a delay in the diagnosis. Recognition of this entity and the use of fine-needle aspiration may prevent unnecessary thyroid surgery, thus maintaining intact thyroid function after therapy.