Pulmonary metastases from thyroid carcinomas are usually detectable on routine chest roentgenograms. In the unusual situation reported here, the chest X ray was completely normal despite widespread pulmonary involvement demonstrated by the I131 chest scintiscan.
CASE REPORT: The patient, a 40-year-old white male, was well until October, 1959. On routine physical examination
FIGURE 1. Chest scintiscan prior to therapy, showing diffuse, bilateral pulmonary uptake of radioiodine.
FIGURE 2. Photomicrograph of lung biopsy, showing follicular thyroid carcinoma with psammoma body formation. (X 400.)a 1-cm nodule was found in the right lobe of the thyroid. In March, 1960, he underwent surgical removal of the right lobe and isthmus, and a diagnosis of follicular carcinoma with papillary features was made. In June, 1960, multiple anterior cervical lymph nodes on the right were