Abstract
Introduction: The thyroid is a very rare site of presentation of primary tuberculosis or associated with miliary tuberculosis, mistaken in most of the cases with other pathologies such as thyroid cancer. Case Report: Here is described a case of primary thyroid tuberculosis with skin fistula and formation of a prevertebral abscess, in a male patient with malnutrition and alcoholism, whose diagnosis was established during the intraoperative frozen section study of hemi-thyroidectomy. Conclusion: Clinical suspicion and following a protocol including fine needle biopsy and intraoperative frozen section study is essential for the diagnosis of thyroid tuberculosis.
Highlights
Contrary to the name, Max Askanazy first described the Hurthle cell in 1898 in patients with Graves’ disease [1]
Risk factors, ultrasound characteristics, and final surgical pathology was retrospectively collected after receiving approval from the Research Ethics Board at Mt
Fine needle aspiration is useful in identifying Hurthle cell lesions, as Zhang reported the true-positive and false-negative rates of fine needle aspiration (FNA) in their series as 89% and 11% respectively [15]
Summary
Max Askanazy first described the Hurthle cell in 1898 in patients with Graves’ disease [1]. What we call a “Hurthle cell” is very different from what Karl Hurthle described in 1894, in his paper entitled “Studies on the Secretory Activity of the Thyroid Gland”, in which he studied the thyroids of dogs [2]. Karl Hurthle described “interfollicular cells” in the thyroids of dogs that were later determined by Roediger in 1975, to be calcitonin producing C-cells [3]. Hurthle cells can be found in other non-neoplastic conditions of the thyroid gland including Hashimoto’s thyroiditis, multinodular goiter, Graves’ disease, and in patients who have been treated with radioactive iodine and systemic chemotherapy [6,7,8,9,10,11,12]. Objectives of this study are to determine what percent of Hurthle cell lesions are found to be malignant on final pathology and to determine if there are demographics, risk factors, or ultrasound characteristics that will preoperatively help predict malignancy
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