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Tuberculosis of the thyroid gland: two case reports.

Baidya A, Singha A, Bhattacharjee R, Dalal BS - Oxf Med Case Reports (2015)

Bottom Line: The other patient had a solitary thyroid nodule with normal thyroid function.Involvement of other organs was absent in both cases.Proper diagnosis may avoid unnecessary surgical interventions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Endocrinology and Metabolism , Institute of Postgraduate Medical Education and Research/SSKM Hospital , Kolkata, West Bengal , India.

ABSTRACT
Tuberculosis of the thyroid gland is a rare entity even in countries like India where tuberculosis is endemic. The patients may present with thyroid swelling, inflammation and very rarely thyroid dysfunction. Caseous necrosis and epithelioid cell granulomas on fine-needle aspiration cytology and histopathological examination are diagnostic. We present two cases of thyroid gland tuberculosis. One patient had subclinical thyrotoxicosis with presentation mimicking acute bacterial thyroiditis. The other patient had a solitary thyroid nodule with normal thyroid function. Involvement of other organs was absent in both cases. Proper diagnosis may avoid unnecessary surgical interventions.

No MeSH data available.


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Leishman Giemsa stain showing an epithelioid granuloma (×40).
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OMV028F4: Leishman Giemsa stain showing an epithelioid granuloma (×40).

Mentions: A 42-year-female presented to the outpatient clinic with weakness, fatigue and loss of appetite for 4 months. She also complained of fever and widespread body ache. She denied cough, sore throat or sputum production. There was no family history of thyroid disorder. There was no history of tuberculosis in the past. On examination, incidentally we found a non-tender, firm, solitary nodule located in the right lobe of thyroid gland. Her vitals were stable and other systemic examinations did not show any abnormality. Biochemically, she was euthyroid with negative anti-TPO antibodies. However, cervical USG showed a solitary nodule with heterogeneous echotexture with no features of malignancy. FNAC showed epithelioid granulomas (Fig. 4). Chest X-ray was unremarkable, but Mantoux test was positive (15 × 15 mm). AFB was not found in smear, but TB-PCR was positive from the aspirate. The patient received WHO Category-1 anti-tubercular regime. Her symptoms improved within 2 months of starting therapy. The patient remained asymptomatic and euthyroid till the last follow-up visit, i.e. 6 months after completion of therapy. The nodule was no longer palpable at that time.Figure 4:


Tuberculosis of the thyroid gland: two case reports.

Baidya A, Singha A, Bhattacharjee R, Dalal BS - Oxf Med Case Reports (2015)

Leishman Giemsa stain showing an epithelioid granuloma (×40).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664839&req=5

OMV028F4: Leishman Giemsa stain showing an epithelioid granuloma (×40).
Mentions: A 42-year-female presented to the outpatient clinic with weakness, fatigue and loss of appetite for 4 months. She also complained of fever and widespread body ache. She denied cough, sore throat or sputum production. There was no family history of thyroid disorder. There was no history of tuberculosis in the past. On examination, incidentally we found a non-tender, firm, solitary nodule located in the right lobe of thyroid gland. Her vitals were stable and other systemic examinations did not show any abnormality. Biochemically, she was euthyroid with negative anti-TPO antibodies. However, cervical USG showed a solitary nodule with heterogeneous echotexture with no features of malignancy. FNAC showed epithelioid granulomas (Fig. 4). Chest X-ray was unremarkable, but Mantoux test was positive (15 × 15 mm). AFB was not found in smear, but TB-PCR was positive from the aspirate. The patient received WHO Category-1 anti-tubercular regime. Her symptoms improved within 2 months of starting therapy. The patient remained asymptomatic and euthyroid till the last follow-up visit, i.e. 6 months after completion of therapy. The nodule was no longer palpable at that time.Figure 4:

Bottom Line: The other patient had a solitary thyroid nodule with normal thyroid function.Involvement of other organs was absent in both cases.Proper diagnosis may avoid unnecessary surgical interventions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Endocrinology and Metabolism , Institute of Postgraduate Medical Education and Research/SSKM Hospital , Kolkata, West Bengal , India.

ABSTRACT
Tuberculosis of the thyroid gland is a rare entity even in countries like India where tuberculosis is endemic. The patients may present with thyroid swelling, inflammation and very rarely thyroid dysfunction. Caseous necrosis and epithelioid cell granulomas on fine-needle aspiration cytology and histopathological examination are diagnostic. We present two cases of thyroid gland tuberculosis. One patient had subclinical thyrotoxicosis with presentation mimicking acute bacterial thyroiditis. The other patient had a solitary thyroid nodule with normal thyroid function. Involvement of other organs was absent in both cases. Proper diagnosis may avoid unnecessary surgical interventions.

No MeSH data available.


Related in: MedlinePlus