This young Caucasian woman presented with history of neck swelling which had been present for many months. There had been no travel to, or contact with persons from areas with endemic TB, no history of smoking or of decreased immunity.

CT examination revealed numerous cystic structures predominantly along the deep cervical lymph node chain. These have thin walls and some areas of calcification. A similar cystic area can be seen in the lateral aspect of the right lobe of thyroid gland. 

FNAC confirmed Papillary thyroid cancer. 

Case courtesy of Dr. Pramit Phal, Royal Melbourne Hospital.