Thyroid Tuberculosis Research Articles

Papillary thyroid cancer (PTC) Coexisting with thyroid tuberculosis: about cases

Papillary thyroid cancer (PTC) Coexisting with thyroid tuberculosis: about cases

Thyroid tuberculosis mimicking multinodular goiter: a case report

BackgroundMycobacterium tuberculosis is the second most common infectious cause of death in adults worldwide. The ability of this organism to efficiently establish latent infection has enabled it to spread to nearly one-third of individuals worldwide. Approximately 8 million new cases of active tuberculosis disease occur each year, leading to about 1.7 million deaths. The disease incidence is magnified by the concurrent epidemic of human immunodeficiency virus infection. A total of 1.3 million people died from tuberculosis in 2022. In 2022, an estimated 10.6 million people fell ill with tuberculosis worldwide, including 5.8 million men, 3.5 million women, and 1.3 million children. We report a case of thyroid tuberculosis presenting as multinodular goiter. Neck ultrasound was done and revealed abscess collection on the background of multinodular colloid goiter. The diagnosis of thyroid tuberculosis was confirmed by a positive GeneXpert of the pus sample and the presence of extensive caseous necrosis on cytopathology examination. Furthermore, anterior neck swelling may provide a diagnostic challenge by clinically mimicking multinodular goiter or thyroid neoplasms. Owing to its rarity and its tendency to pose a clinical diagnostic challenge, we decided to report it.Case presentationA 60-year-old retired female Ethiopian high-school teacher presented to University of Gondar Hospital, Gondar, Ethiopia with firm, nontender multinodular anterior neck swelling measuring at largest 2 × 3 cm that moves with swallowing. GeneXpert of the pus sample and cytopathology examination confirmed the diagnosis of thyroid tuberculosis, and the patient was started on 2 rifampicin−ethambutol−isoniazid−pyrazinamide/4 rifampicin−isoniazid 3 tablets by mouth/day, which is defined as the preferred first-line anti-tuberculosis regimen in Ethiopia, and pyridoxine 50 mg by mouth per day for 6 months. Since then, she has been followed with regular liver function tests. The patient has shown a smooth course with no significant adverse effects encountered. Currently, the patient has completed her anti-tuberculosis treatment and is doing well.ConclusionIn the clinical evaluation of a patient with anterior neck swelling, tuberculosis must be considered as a differential diagnosis in subjects from endemic areas for early diagnostic workup and management.

Incidental Discovery of Thyroid Tuberculosis on Isthmolobectomy Example: Clinical Case

Thyroid tuberculosis remains a rare clinico-histological entity. The clinical symptomatology is non-specific, mainly made by a goiter or thyroiditis with a subacute or chronic evolution. The diagnosis of certainty is confirmed by pathological examination of the thyroidectomy specimen. Anti-bacillary treatment of classic tuberculosis allows complete cure.

Thyroid tuberculosis mimicking carcinoma: A case report and review of the literature

Thyroid tuberculosis (TT) is a very rare condition, even in endemic countries, this can be explained by the high resistance of the thyroid gland to infections. It can be primary or secondary to disseminated infection. A solitary thyroid nodule is the most common reason for consultation, and can present in the form of a cystic nodule. He can even present a picture of a thyroid abscess with pain, fever, and other nonspecific signs and symptoms. We present the case of a 65-year-old woman who consulted for a lower median cervical swelling that had been present for 4 years associated with upper right laterocervical lymphadenopathy mimicking a thyroid carcinoma. As symptoms and imaging features are nonspecific, diagnosis is challenging. Fine-needle aspiration cytology is a useful technique for preoperative diagnosis. Typical caseous necrotic granulomas are the hallmark in histological examination. Thyroid tuberculosis should be considered in the differential diagnosis of a thyroid nodule and of neck mass, in order to prevent unnecessary surgery. Histopathology and culture of MTB remain a key step for the diagnosis.

Thyroid tuberculosis associated with papillary microcarcinoma: case report and review of literature

Introduction: Thyroid tuberculosis (TB) is extremely rare. Infection may first occur in the thyroid gland or may be secondary to TB in other parts of the body. The diagnosis is rarely made clinically because the disease’s variable presentation often resembles that of a malignancy or an euthyroid nodular goiter. Case report: We present the case of a 40-year-old woman, who presented multiple thyroid nodules in both lobes. Two of these nodules were classified as EU-TIRADS V (European Thyroid Imaging and Reporting Data System). The ultrasound also found an adenopathy of the inferior part of the jugular lymphatic chain, in favor of malignancy. The histopathological examination after total thyroidectomy showed thyroid TB, associated to a papillary microcarcinoma of the right thyroid lobe, and the final examination of the adenopathy showed similar granulomas with caseous necrosis, and no signs of metastasis. Clinical discussion: Thyroid TB is very rare. Its diagnosis is difficult due to a lack of specific signs and symptoms, which is why the diagnosis is most commonly made on pathological examination after thyroid surgery. It is well known that mycobacterial infection creates an environment of chronic and persistent inflammation, with possible DNA damage. This can create a microenvironment that is highly conductive to carcinogenesis, which could explain the discovery of papillary microcarcinoma in addition to thyroid TB in our patient. Conclusion: This report presents a rare case of malicious growth development of thyroid nodules and thyroid TB. Therefore, physicians must always be vigilant when managing thyroid nodules, as there is always the possibility of malignant lesions associated to an inflammatory or infectious cause.

Thyroid Tuberculosis: Case Report

Introduction: Thyroidal tuberculosis is a rare entity. The clinical presentation is not specific. The purpose of our observation is to underline the diagnostic problems posed by thyroid tuberculosis. Observation: We report a case of a 60 years old female patient with neck swelling related to a tuberculous infection, who received a anti-tuberculosis therapy. Discussion: This localization is often secondary, and exceptionally primary it is favored by advanced age, diabetes, malnutrition and HIV infection. The clinical presentation is not specific. It evolves in a chronic or subacute mode. The presence of another tuberculous localization concomitant allows to evoke the diagnosis. A thyrotoxicosis or hypothyroidism can be observed. The differential diagnosis includes, besides thyroid cancer, all other disorders of the gland. The appearance on imaging is not specific and the fine-needle aspiration cytology is only of value when it is positive. Only pathological examination confirms the diagnosis. The treatment is medical and surgical in case of complications. Conclusion: Thyroid tuberculosis is a differential diagnosis that should be considered in front of a cold nodule in a clinical or epidemiological evocative context.

Primary thyroid tuberculosis mimicking papillary carcinoma of thyroid: a rare case report.

A 54-year-old female presented with recent onset dysphagia and foreign body sensation in the throat for 3 months, and anterior neck swelling since last 10 years. A single nodular firm anterior neck swelling was present which moves with deglutition. Thyroid function test was normal. Ultrasonography thyroid revealed TIRADS-3. Fine-needle aspiration cytology was suggestive of papillary carcinoma of thyroid. Total thyroidectomy with central compartment neck dissection was performed. Histopathology of the thyroid specimen revealed tubercular thyroiditis. Postoperatively, Mantoux test and interferon gamma radioassay were positive. Antitubercular therapy was given for total of 6 months. With ultrasonography-guided fine-needle aspiration cytology, preoperative diagnosis of primary thyroid tuberculosis is quite challenging even in tuberculosis endemic countries. So, it should be considered one of the differential diagnoses despite negative relevant history and without clinical cervical lymph nodes involvement with cytology proven suspicious papillary thyroid cancer before proceeding for surgical intervention.

Multi-heteronodular goiter revealing thyroid tuberculosis: A case report

Thyroid tuberculosis is a rare entity. The clinical symptomatology is non-specific with a picture of goiter or thyroiditis with a subacute or chronic evolution. We report an observation of thyroid tuberculosis in a 39 year old female patient presenting with a nodular thyroid goiter without general manifestations. The diagnosis was confirmed by anatomopathological examination of the total thyroidectomy specimen. Antituberculosis treatment was initiated for six months with a favorable clinical course.

Diagnostic and Management Guidelines of Thyroid Tuberculosis: Our Experience and Systematic Review.

Thyroid tuberculosis has non-specific clinical presentation, difficult diagnosis and specific medical management. The aim of this article is to present and share a review of the English-language literature on thyroid tuberculosis in order to gain a better understanding of diagnostic methods and provide guidelines for its management and to present our experience of three cases. The systematic search of the literature was performed on Pubmed and Medline from 1950 to 2019 according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. We retrieved 13 manuscripts meeting our criteria from the search. There were 7 case series, and 6 manuscripts with review of the literature. Direct histopathological demonstration is the best diagnostic modality. FNAC is the study of choice and PCR assay increases its sensitivity. The standard short course ATT for 6months is recommended for isolated thyroid TB and for widespread disease, 12months therapy is recommended. Surgery is reserved for failure of medical therapy and abscess formation.

Thyroid tuberculosis: rare location or rarely diagnosed? Literature review

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.

Clinical diagnosis and treatment of primary thyroid tuberculosis: a retrospective study.

ABSTRACTBACKGROUND:Primary thyroid tuberculosis (PTT) is an uncommon type of extrapulmonary tuberculosis, which is caused by Mycobacterium tuberculosis. It does not have specific clinical manifestations, and most cases are diagnosed through postoperative histopathological examination.OBJECTIVE:To evaluate the diagnostic pattern and management strategy among patients with primary thyroid tuberculosis.DESIGN AND SETTING:Retrospective study on patients with primary thyroid tuberculosis in the First Hospital of Jilin University (Changchun, China).METHODS:Between March 2015 and June 2020, nine cases of PTT were diagnosed and treated in the Department of Thyroid Surgery of the First Hospital of Jilin University. Age at diagnosis, primary symptoms, preoperative biopsy, operation method, pathological classification, acid-fast staining test, anti-TB therapy and prognosis were registered in order to explore the appropriate protocol for diagnosis and treatment of this disease.RESULTS:None of the patients was diagnosed with thyroid tuberculosis before surgery. All the patients underwent surgery. Granulomatous changes or caseous necrosis in thyroid tissue were found through postoperative histopathological evaluation. Polymerase chain reaction (PCR) results for Mycobacterium tuberculosis were positive in all patients. Most patients had a good prognosis after surgery and anti-tuberculosis drug therapy.CONCLUSION:PTT is a rare disease. It is important to improve the preoperative diagnosis. Preoperative diagnostic accuracy relies on increased awareness of the disease and appropriate use of preoperative diagnostic methods, such as PCR detection, fine-needle aspiration cytology, acid-fast bacillus culture, ultrasound and blood sedimentation. PCR detection of M. tuberculosis is recommended as the gold standard for diagnosis.

Thyroid tuberculosis: a case report

Thyroid tuberculosis: a case report

A Case of Primary Thyroid Tuberculosis Presenting with Multinodular Goiter

Thyroid tuberculosis is a very rare condition with a rate of 0.1-1.15% even in countries with a high prevalence of tuberculosis. In this presentation, we evaluated the management of a patient with a preoperative diagnosis of benign tissue and a pre-diagnosis of multinodular goiter with compression symptoms. After thyroidectomy of our patient who had no special history due to the detection of Langerhans giant cell caseified granuloma-thyroid tuberculosis, postoperative thyroid replacement therapy and infectious diseases outpatient control were planned. Thyroid tuberkulosis is not easy to diagnose because there are no specific symptoms. If no other foci are detected after total thyroidectomy, close follow-up is recommended without additional antituberculosis therapy. As the incidence of tuberculosis increases worldwide, thyroid tuberculosis as the unusual involvement of extrapulmonary tuberculosis; it should be kept in mind in the differential diagnosis of nodular lesions of the thyroid gland.

Cold abscess as a primary manifestation of thyroid tuberculosis

Tuberculosis remains the highest cause of infection-related mortality in low- and middle-income countries. Extra-pulmonary tuberculosis is often misdiagnosed because of the nonspecific clinical presentations and gaps in the laboratory assessment. Delayed and misdiagnosis can cause increased risks of morbidity and potential community transmission. Primary thyroid tuberculosis is very rare presentation even in the endemic area. We presented a Case Illustrated of a patient with cold abscess as a primary presentation of thyroid tuberculosis. Difficulty in the diagnosis and treatment were described. Although very rare, atypical presentation of extra-pulmonary tuberculosis in the thyroid gland requires thorough anamnesis and in-depth examination. Clinicians should put high-index suspicion on high-risk patients from endemic areas with medical comorbidity including immunocompromised disease and poor nutritional status. Our report underlines the importance of thorough medical assessment for unusual presentation of thyroid tuberculosis.

Primary Tuberculosis of thyroid gland

Tuberculosis of thyroid gland is rare entity and primary involvement of thyroid is still rarer, even in the endemic areas. The clinical case may mimic toxic goitre, hashimoto’s thyroiditis, bacterial or fungal infection. Sometimes thyroid malignancy may be mistaken for thyroid tuberculosis. Our patient who presented with fever, diffuse goitre with positive mantoux and histopathology revealed caseous necrosis and positive for acid fast bacilli, compatible with tuberculosis.

Extraganglionary Localization of Tuberculosis in Otorhinolaryngology: Rare Presentations About 29 Cases

The extra nodal tuberculosis is a rare disease in Ear, Nose and Throat. The aim of this work is to study the epidemiological, clinical, therapeutic profiles of rare locations of ENT extra nodal tuberculosis. This is a retrospective study between June 2003 and June 2019, including 29 cases of ENT extra nodal tuberculosis. There were 6 cases of laryngeal tuberculosis, 5 cases of nasopharyngeal tuberculosis, 5 cases of salivary gland tuberculosis, 3 cases of tonsillar tuberculosis, 1 case of tuberculous retropharyngeal abscess, 3 cases of nasal tuberculosis, 3 cases of tuberculosis of the middle ear, 1 case of thyroid tuberculosis, 1 case of tuberculosis of the bony palate, and 1 case of mandibular tuberculosis. All ages were affected with a predominance of young adults. The clinical signs, as well as radiological or endoscopic examinations, were not specific. The diagnosis was based on histology and/or bacteriology. Antibacillary therapy was instaured in all cases. Extra nodal tuberculosis in ENT is rare. It is dominated by the laryngeal location. It must be considered as a differential diagnosis in front of any atypical symptoms, particularly in endemic countries.

A 17-Year-old Boy With Nodular Lesions in the Thyroid and Lymphadenopathy.

A 17-Year-old Boy With Nodular Lesions in the Thyroid and Lymphadenopathy.

'Primary Thyroid Tuberculosis'-The Masquerader: A Case Report.

Tuberculosis of thyroid is a rare entity even among highly prevalent regions of tuberculosis. Primary tuberculosis of thyroid is even more rarer. The reason is attributed to the inherent relative immunity of the thyroid gland. Clinical manifestation is unpredictable accounting to both asymptomatic and variable benign and malignant mimicking symptoms. Clinical course may too vary depending on the thyroid dysfunction and complications. Aspiration cytology is diagnostic, though the yield is low. Histological diagnosis, depicting caseating granuloma added with acid fast staining confirms the diagnosis. High clinical suspicion is to be maintained to prevent total thyroidectomy.

A Case of Papillary Thyroid Cancer Coexisting with Thyroid Tuberculosis

A Case of Papillary Thyroid Cancer Coexisting with Thyroid Tuberculosis

Increased angiogenesis in thyroid tuberculosis identified by SPECT/CT based on RGD dimer radiotracer (99mTc-3PRGD2)

To evaluate the enterohepatic circulation of 75-Selenium turoselecolic acid (75Se-SeHCAT) during the first 3 h and its correlation with the abdominal retention at the 7th day (AR7), as contribution to the clinical study of biliar acid malabsorption (BAM).38 patients with chronic diarrhea were retrospectively studied. Acquisition protocol included static abdominal images at 1st, 2nd and 3rd hour and the 7th day after oral administration of the radiopharmaceutical. Images of 1–3 h determined 5 patterns of enterohepatic circulation that, due to their location, were characterized as: 1) gallbladder 2−3 h, 2) gallbladder 3 h, 3) gallbladder-abdomen 2−3 h, 4) abdomen, 5) upper left abdomen. The association of these patterns with the AR7 (Fisher, STATA) were investigated. Patients were classified as Non BAM (AR7 > 15%), mild-BAM (AR7 15−10%), moderate-BAM (AR7 10−5%) or severe-BAM (AR7 < 5%).19 patients had an AR7 diagnostic of BAM (7 mild-BAM, 5 moderate-BAM, 7 severe-BAM). The pattern “gallbladder at 2−3 h” was statistically associated with Non BAM (p 0,008), while “gallbladder-abdomen at 2−3 h” was correlated with having BAM (p 0,029).Variations detected at the abdominal level in images during the first 3 h were associated with changes in intestinal absorption and the incorporation of the radiopharmaceutical into the pool of bile acids, so visual interpretation of the images at 2nd and 3rd hour could be useful in the final assessment of the study.Evaluar la circulación enterohepática del ácido tauroselcólico marcado con 75-Selenio (75SeHCAT) durante las 3 primeras horas y su correlación con la retención abdominal al 7º día (RA7), como aportación al estudio clínico de malabsorción de ácidos biliares (MAB).Se estudiaron de forma retrospectiva 38 pacientes con diarrea crónica. El protocolo de adquisición incluyó imágenes estáticas abdominales a la 1ª, 2ª y 3ª hora y al 7º día tras la administración oral del radiofármaco. Las imágenes de 1 a 3 horas determinaron 5 patrones de circulación enterohepática que por su localización se caracterizaron como: 1) vesícula biliar 2−3 horas, 2) vesícula biliar 3 horas, 3) vesícula biliar-abdomen 2−3 horas, 4) abdomen y 5) abdomen superior izquierdo. Se investigó la asociación de estos patrones con la RA7 (Fisher-STATA). Los pacientes se clasificaron como No MAB (RA7 > 15%), MAB-leve (RA7 15−10%), MAB-moderado (RA7 10−5%) o MAB-grave (RA7 < 5%).19 pacientes presentaron una RA7 diagnóstica de MAB (7-leve, 5-moderada, 7-grave). El patrón “vesícula biliar a las 2−3 horas” se asoció estadísticamente con la No MAB (p 0,008), mientras que el de “vesícula biliar-abdomen a las 2-3 horas” se correlacionó con padecer MAB (p 0,029).Las variaciones detectadas a nivel abdominal en las imágenes durante las 3 primeras horas están asociadas a los cambios de absorción intestinal e incorporación del radiofármaco al pool de los ácidos biliares, por lo que la interpretación visual de las imágenes a la 2ª y 3ª hora podría tener utilidad en la valoración final del estudio.