Thyroid tuberculosis: rare location or rarely diagnosed? Literature review

Abstract

Objective — to study of the frequency, clinical picture, diagnosis and treatment of tuberculosis of thyroid gland.
 Materials and methods. Analyses the date of the world experience and own observations.
 Results and discussion. Thyroid tuberculosis is a less frequent localization of this disease. Currently, most authors believe that thyroid tuberculosis is diagnosed in 0.1–1 % of all known cases of tuberculosis. Clinical observations have found that the thyroid gland is more often involved in the tuberculous process with a generalized miliary process, and, as previously thought, in this case there are no clinical signs of damage to the thyroid gland. A variable clinical presentation of thyroid tuberculosis was demonstrated. It is usually presented with local symptoms associated with diffuse enlargement of the thyroid gland. It is difficult to estimate the quantity of diagnosed cases due to insufficient knowledge of the doctors about this pathology and difficulties of tuberculosis etiology diagnosis. Tuberculous etiology must be ruled out in all lesions on the median surface of the neck. Fine-needle biopsy can help to confirm the diagnosis of thyroid tuberculosis, but the final diagnosis is possible only with histological or cytological studies. The diagnosis of thyroid tuberculo­sis requires the use of most of all the methods used in the diagnosis of tuberculosis: from the simplest (such as X-ray or Mantoux test (with 2 international units of tuberculin) methods to modern rapid molecule-genetic tests XpertMTB/Rif that detect specific fragments of MTB DNA in serum or plasma). Ultrasound and computer tomography also help the clearing of the diagnosis. Surgical treatment in combination with antimycobacterial chemotherapy is effective. 
 Conclusions. Further investigations are needed to understand the definition, diagnosis and treatment of tuberculosis among other diseases of thyroid.