Neck CT Scan: (neck) multiple enlarge lymph nodes bilaterally some of them enhancing after contrast injection

-very large tumor mass lesion in the lower part in the neck extending from the thyroid gland right more than left with compression and displacement of the trachea and esophagus to the left side the mass lesion appear heterogenecity irregular infiltrative with bone erosion involving the vertebral body T1 causing compression of the spinal cord.

Early heterogenecity of the vertebral body T2

No other abnormality detected finding typical for local infiltrative aggressive tumor mass lesion extending from the thyroid gland with lymphatic metastasis with destruction of the vertebral bodies the same level mainly T1 with infiltration to the dura and causing severe compression of the spinal cord at the same level no significant sign of metastasis to the brain tissue at level of examination

Size of mass 7x5cm lymph node enlargement Rt. side more than Lt.

Mainly at supra clavicular space.

-normal vascular structures of the neck with no evidence of pathologically vascular enhancing lesions

-normal laryngeal air-way, laryngeal cartilages with no evidence of soft tissue masses cartilage destruction

镜下可见核分裂像，核沟个别似有，不明显

乳头状癌

低分化癌。1.原发。2.转移。

光看HE，不看CT的话，首先恶性是肯定的吗？然后那那滤泡结构好像很明显，应该是有甲状腺成分的；但乳头结构的细胞核好像没有乳头状癌的特点；

最后我添的那个图，不像鳞巢吗？

细胞有异型，但要直接诊断癌或什么的，还真有些困难。建议切取组织送检。

凭形态不能直接下癌

 椒盐核，小核仁，符合髓样癌，期待手术病理结果

考虑乳头状癌