Hyalinising trebecular adenoma (HTA) of the thyroid is rare and controversies remain regarding the diagnosis and management. It is an uncommon benign thyroid tumour that can present as a solitary thyroid nodule, a prominent nodule in a multinodular goitre, or as an incidental finding in a thyroidectomy specimen. Some considered HTA a unique entity, while others have proved it to be a variant of papillary carcinoma or have considered it a nonspecific pattern that may be seen with a variety of thyroid lesions. We report the case of a 31-year-old Chinese lady who presented with four years history of right sided goitre that was gradually increasing in size. Fine needle aspiration cytology showed appearances of follicular adenoma. Intra-operative frozen section histology of the excised right thyroid lobe was reported as trabecular adenoma which was confirmed with histopathological examination.

A 25-year-old Malay lady who was six month pregnant presented with a three day history of fever, malaise, odynophagia, dysphagia, trismus and change in voice. On clinical examination, she was dehydrated, mouth breathing and had foetid breath. She also had ‘hot potato-sounding’ speech. Examination of her oral cavity revealed oedematous and erythematous soft palate with inferior and medial displacement of the tonsils (Panel). There were also bilateral, solitary and tender jugulodigastric nodes. What is the diagnosis? Answer: refer to page 156

(Refer to page 134) Answer: Peritonsillar abscess/ Quinsy Peritonsillar abscess or quinsy is a collection of pus in the potential space between the fibrous capsule of the palatine tonsil and superior constrictor muscle of the pharynx, usually at its superior pole. Over 50% of the patients will have a previous history of tonsillitis. In our case, the patient had unilateral peritonsillar abscess a year earlier which required incision and drainage. Although beta-haemolytic Streptococcus is frequently isolated, mixed aerobic and anaerobic pathogens are also seen. 1