Thy3 cytology: what to do next?

Introduction: Cytological analysis of thyroid fine needle aspiration (FNA) is aided by the 'Thy' classification. However, there is often confusion surrounding the management of patients with a Thy3 classification. A subdivision of Thy3 has been created to help reduce this dilemma but its use within the UK appears to by infrequent.

Lemierre's syndrome as a consequence of acute supraglottitis.

Lemierre's syndrome comprises internal jugular vein thrombosis following oropharyngeal sepsis and is a rare and serious condition. It is most commonly caused by the anaerobe Fusobacterium necrophorum and typically presents as metastatic sepsis to the lungs and joints. Thrombosis is demonstrated by computed tomography (CT) of the neck, and it is routinely treated with intravenous antibiotics and anti-coagulation.

Medial orbital protrusion--a potentially hazardous anomaly during endoscopic sinus surgery.

We report the case of a 57-year-old patient with a presumed developmental anomaly of the medial orbital wall. The resultant protrusion of orbital contents into the ethmoidal complex was clearly demonstrated on coronal computed tomography (CT) scans of the paranasal sinuses. This anomaly presents a high risk of iatrogenic injury to the medial rectus and orbit during functional endoscopic sinus surgery and has not previously been described.

A clinic for the rapid processing of patients with neck masses.

Neck masses are common and may have serious underlying pathology. There is much anxiety and confusion in primary care as to which hospital department will provide the patient with the best service and the swiftest diagnosis. A clinic was set up at Wexham Park hospital to enable patients with neck masses to be seen early, and to undergo a one-stop specialist evaluation, ultrasound scan and fine needle aspiration biopsy.