Diagnosis Of Thyroid Tuberculosis Research Articles

SUN-588 Primary Tuberculosis of the Thyroid Gland: A Case Series

Background:Tuberculosis (TB) of the thyroid gland is a rare occurrence even in regions where TB is endemic. This affects about 0.1% of the population with TB and remains to be underdiagnosed due to the rarity of the condition. Case: We report three cases of TB of the thyroid. The first patient is a 60 year old female who presented with anterior neck mass with no obstructive symptoms, neck pain or fever. There were no signs nor symptoms of hyperthyroidism or hypothyroidism. She also has no history of tuberculosis. Ultrasound showed multiple thyroid nodules. Ultrasound guided FNABof the left nodule was done revealing chronic granulomatous inflammation with necrosis. The second case is a 60 year old male presenting with a history of painful, marble-sized right neck mass for 1 month accompanied by occasional low grade fever, weakness and weight loss. An ultrasound guided FNAB was performed revealing polymorphic lymphoid cells with occasional giant cells consistent with granulomatous thyroiditis. The third case is a 37 year old female presenting with an enlarging anterior neck mass with concomitant abscess. She complained of neck pain and dysphagia. Incision and drainage of the abscess was done. Microbiological studies revealed negative AFB with chronic granulomatous lymphadenitis and caseation necrosis. Mycobacterium culture and polymerase chain reaction were negative as well. Ultrasound of the thyroid gland revealed a left thyroid mass measuring 2.1 x 3.5 x 4.1 cm. Result: The first case was referred to an infectious disease specialist but was lost to follow up. The second casecompleted treatment for 6 months with anti Koch’s medications and on repeat ultrasound, there was decrease in the size and number of the nodules. The third case underwent thyroid lobectomy with histopathologic criteria for TB hence a diagnosis of thyroid TB was made. The patient was given anti-Kochs treatment. Conclusion: Though rare, tuberculosis of the thyroid should be one of the differential diagnoses of patients presenting with neck masses in communities where the prevalence of TB is high even in patients with no history of TB.

Discharging sinus of neck after thyroid surgery:A rare case report

There are a number of complications after thyroid surgery such as compressing hematoma, tracheomalacia, wound infection, damage to the recurrent laryngeal nerve or superior laryngeal nerve, hypothyroidism, hypocalcemia, scar formation, and thyroid storm, but discharging skin sinus of the neck is a rare complication. We report a case of discharging pus sinus of the neck after hemithyroidectomy for 1 year; pus culture was positive for Pseudomonas aeruginosa. Thyroid function test was normal. Ultrasonography disclosed branching sinus tracts and right lobe thyroid nodule and the left lobe not visualized. Sinus tracts' excision surgery was done. Histopathology report revealed fibrocollagenous stroma with clusters of epithelioid cells, histiocytes, Langhans giant cells, and chronic inflammatory cells with foci of caseous necrosis. The diagnosis of thyroid tuberculosis (TB) was therefore made. Patient was put on isoniazid, rifampicin, ethambutol, and pyrazinamide. She responds well. Although seldom observed, TB should be kept in mind in the differential diagnosis of discharging sinus of neck.

Thyroid tuberculosis

Tuberculosis (TB) is one of the leading causes of morbidity and mortality, and about one-third of the world population is suffering from this disease. It has been reported in many body parts, but the involvement of thyroid by TB whether primary or secondary is extremely uncommon. We report a case of 60-year-old female presenting with thyroid swelling since 4 weeks. Diagnosis of thyroid TB was made after fine-needle aspiration cytology and confirmed by the detection of acid-fast bacilli by Ziehl–Neelsen stain. The patient was put on antitubercular therapy following which he showed dramatic clinical improvement with resolution of the nodular swelling.

Primary Tuberculosis of the Thyroid Gland Presenting as a Cystic Lesion: Report Two Cases

Tuberculosis of thyroid gland (TTB) is extremely uncommon. The incidence is low even in countries where the prevalence of tuberculosis (TB) is endemic and high. The diagnosis is often difficult as the clinical presentation has no distinct characteristics. We report two case of Primary Tuberculosis of the thyroid gland (PTTB) ,one was A 56-year-old man with a lump on the left side of his lower neck. He noticed the swelling 12 weeks prior to presentation and it had been gradually increasing in size. Another was, a 72-year-old man presented with history of left thyroid lobe swelling for 5-7 month, which was gradually increasing in size Ultrasonography disclosed nodules of the left lobe with cystic change. Thyroid function tests were in the normal range, there were no signs of inflammation. There was no evidence of tuberculosis in any other organ.FNA from left lobe of thyroid was performed which yielded purulent aspirate. Smears examined show degenerated inflammatory cells in a necrotic background No follicular epithelial cells were seen. The patients had surgery in which the left lobe was removed. Microscopic examination of the thyroid parenchyma revealed necrotizing epithelioid granulomas with Langhans giant cells. The diagnosis of thyroid tuberculosis was therefore made. The patients was put on isoniazid, rifampicin, ethambutol and pyrazinamid for 2 months and was subsequently given isoniazid and rifampicin for 4 months with a favourable outcome. Although seldom rare presentation of (TTB) observed, tuberculosis should be kept in mind in the differential diagnosis of nodular or cystic lesions of the thyroid.

Hurthle Cell Lesions- A Retrospective Review of Final Surgical Pathology

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.

Subacute thyroiditis complicated by extra-thyroidal abscess: A very rare presentation of tuberculous thyroiditis

Tuberculosis of the thyroid gland is a very rare condition. We report a case of tuberculous thyroiditis in a young woman who presented with a right-side solitary thyroid nodule associated with features of subacute inflammation of a short duration. Diagnosis was confirmed by fine needle aspiration cytology (FNAC) with positive Ziehl Neelsen staining for acid-fast bacilli (AFB) and positive culture for Mycobacterium tuberculosis. The patient was treated medically with satisfactory resolution of the infection and regression of the nodule. Conclusion: FNAC provides a confident non-operative diagnosis of thyroid tuberculosis, obviating the need for unnecessary surgical removal of a thyroid nodule readily treated medically.

Tuberculous Infection of Thyroid Gland: A Case Report

Introduction. Tuberculosis is one of the leading causes of morbidity and mortality and almost one-third of the world is infected with this disease. Tuberculosis has been reported in many parts of the human body. But thyroid gland involvement is extremely rare and its true incidence is unknown. Case Presentation. We present the case of a 26-year-old woman who presented with a thyroid cyst which turned out to be a primary mycobacterium tuberculosis infection. Conclusion. The correct diagnosis of thyroid tuberculosis is important because of the availability of medical treatment and the limited role of surgery.

Primary tuberculosis of the thyroid gland

Thyroid tuberculosis is a rare disease even in countries in which tuberculosis (TB) constitutes an endemic disorder. The diagnosis is often difficult as the clinical presentation has no distinct characteristics. We report a 47-year-old woman who presented with a painful nodular swelling of the neck, confirmed by physical examination and sweating. Ultrasonography disclosed nodules of the pyramidal lobe with cystic change, and bilateral multiple hypoechogenic lymph nodes along the jugular and carotid chains. Thyroid function tests were in the normal range, there were no signs of inflammation and the tuberculin test was negative. There was no evidence of tuberculosis in any other organ. The patient had surgery in which the pyramidal lobe was removed. Microscopic examination of the thyroid parenchyma and the excised lymph node revealed necrotizing epithelioid granulomas with Langhans' giant cells. The diagnosis of thyroid tuberculosis was therefore made. The patient was put on isoniazid, rifampicin, ethambutol and pyrazinamid for the subsequent 2 months and was subsequently given isoniazid and rifampicin for the subsequent 6 months with a favourable outcome. Although seldom observed, tuberculosis should be kept in mind in the differential diagnosis of nodular lesions of the thyroid.

US and CT findings of tuberculosis of the thyroid: three case reports

With two ultrasonographic and two CT films of three cases of thyroid tuberculosis, we evaluate the ultrasonographic and CT findings and correlate them with the pathologic findings. They are demonstrated as heterogeneous hypoechoic mass on ultrasonogram and peripheral-enhancing low-density abscess on CT scan with regional lymphadenopathy. Ultrasonography (US) and CT can help the diagnosis of thyroid tuberculosis.