Vol. 8, Issue 4, Part B (2025)

Fine-Needle Aspiration Cytology (FNAC) is the primary diagnostic tool for thyroid nodules. Similarly, lymph node FNAC helps to reach the initial diagnosis of malignancy and to differentiate them from benign reactive lymph-nodes.​ We present a rare case of a 50-year-old female diagnosed with synchronous malignancies, including Hodgkin lymphoma (HL) and Papillary Thyroid Carcinoma (PTC). The 50-year-old female presented with high-grade fever, fatigue, and backache for 11 months. Imaging studies, including ultrasonography (USG) and contrast-enhanced computed tomography (CECT), revealed multiple lymph nodes in the pre-aortic, para-aortic, right common iliac, and external iliac regions. USG of the neck showed a TIRADS 4 lesion in the left thyroid lobe, bilateral cervical lymphadenopathy, and a left supraclavicular nodal mass. Fine needle aspiration cytology (FNAC) from the lymph nodes was done and diagnosis of Hodgkin Lymphoma was given. USG-guided FNAC from the thyroid lesion revealed high cellularity and findings were suspicious for Papillary Thyroid Carcinoma, (Bethesda Category V). The patient was referred to a higher oncology center where biopsy of the right inguinal node confirmed HL on histopathology and the thyroid FNAC findings were corroborated at the oncology center, confirming Bethesda Category V diagnosis. In this case report, diagnostic potential of cytopathological analysis of FNA specimens is highlighted in early and accurate diagnosis the rare synchronous dual malignancy of HL and PTC; hereby prompting timely appropriate patient management.