Amyloid Goiter: Clinicopathological Assessment of Two Cases and Review of Literature

Rabab Ahmed Ahmed Mohammed,Badawy Mohammed Ahmed,Alaa M Abozied,Etemad Helmy Yassin,Lobna F Ettouny,Moustafa Ezeldien M Radwan

doi:10.4236/ojpathology.2015.51004

Rabab Ahmed Ahmed Mohammed, Badawy Mohammed Ahmed + Show 4 more

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https://doi.org/10.4236/ojpathology.2015.51004

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Abstract

Amyloid goiter (AG) is a rare but well-established disease entity that may occur in a number of conditions. In the following article, we will report two cases of AG. Both patients were young males: 28 & 24 years old, presented with rapidly enlarging thyroid gland manifested with pressure effects (dyspnea and hoarseness of voice). Provisional clinical diagnosis was malignant thyroid neoplasm. One of the patients was markedly hypothyroid while the other was euthyroid. Histopathological evaluation revealed extracellular deposition of deep pink homogenous material that was confirmed as amyloid with congo red. Patient in case 1 was primary localized AG while patient in case 2 was systemic amyloidosis secondary to interstitial pulmonary fibrosis (IPF) that was first manifested by AG. The main aims of the article were to describe histopathological features of amyloidosis of the thyroid gland and to raise awareness of AG to be included in the differential diagnosis in patients presented with rapidly enlarging goiter with mass effects.

Highlights

IntroductionDeposition of amyloid in the thyroid gland may occur in a number of different disease conditions
Amyloid goiter (AG) is thyroid enlargement caused by deposition of amyloid protein
In the following article we describe two cases of stage III AG, the first case is primary organ-isolated AG while the second case is AG secondary to interstitial pulmonary fibrosis (IPF) with possible systematic affection

Summary

Introduction

Deposition of amyloid in the thyroid gland may occur in a number of different disease conditions. It occurs in about 50% to 70% of medullary thyroid carcinoma, secondary to long standing inflammatory conditions such as rheumatoid arthritis [2], cystic fibrosis [3] [4], ankylosing sponilitis [5] and Crohn’s disease [6]. AG may be secondary to long standing chronic infectious inflammatory diseases such as bronchiectasis [7] and tuberculosis [8]. The condition was reported in association with renal failure [9], nephritic syndrome [10] and familial Mediterranean fever (FMF) [11]. AG was reported in 80% of patients with secondary amyloidosis and in 50% of patients with primary amyloidosis [1]

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