BMJ Case Reports 2018; doi:10.1136/bcr-2018-226581
  • Images in…

Goitre, lymphoma and the doughnut sign

  1. Deepesh Lad
  1. Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Kundan Mishra, mishrak20{at}
  • Accepted 22 August 2018
  • Published 8 September 2018


A 65-year-old woman, with a known case of Hashimoto’s thyroiditis on eltroxin for 15 years, presented with progressive diffuse swelling neck for 2 months. She also gave a history of difficulty in swallowing and breathing for 1 week. On examination, she had respiratory distress, low oxygen saturation (85% on pulse oximeter) and cyanosed tongue. Systemic examination was unremarkable except for goitre (grade 2) and stridor. As the saturation was not improving with supplemental oxygen, she underwent an …

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