A 42-year-old with a non-tender lump on the right side of the neck that moves with swallowing and has no lymphadenopathy most likely has which diagnosis, and which test confirms it?

• A. Thyroid nodule; Fine-needle aspiration biopsy
• B. Lymphadenopathy; Ultrasound
• C. Parathyroid adenoma; CT scan
• D. Salivary gland tumor; MRI

Answer: (A)

A lump in the neck that moves with swallowing points to a thyroid origin because the thyroid sits in the lower neck and moves when the larynx and surrounding structures move during swallowing. The lack of lymphadenopathy makes an infectious or inflammatory node less likely, and the solitary, anterior-neck location fits a thyroid nodule rather than a salivary gland or parathyroid lesion.

To confirm this diagnosis and evaluate the nodule, fine-needle aspiration biopsy is used. This tiny sample from the nodule provides cytology that helps distinguish benign thyroid nodules (like colloid nodules) from malignancy. Ultrasound often accompanies the workup to characterize the nodule and guide the biopsy, but the definitive confirmation comes from the cytology obtained with the needle.