Introduction: The involvement of the thyroid gland by tuberculosis is extremely uncommon even in countries in which tuberculosis is endemic. In the majority of the reported cases, thyroid function was preserved. Herein we report a case of thyroid tuberculosis in a patient with a primary hypothyroidism.
Case report: A 52-year-old woman was referred to our department for a gradually growing goiter without compressive symptoms. She presented with a productive cough. Her Past medical history included type 2 diabetes mellitus, goiter and primary hypothyroidism in the last fifteen years. On examination, she had a plunged multinodular goiter. The rest of the clinical examination and laboratory tests were normal. Chest radiography showed a nodule located in the right lung upper lobe. Cervical ultrasonography revealed an enlarged heterogeneous multinodular thyroid gland. Total thyroidectomy and lung nodule biopsy were performed to the patient. Thyroid histopathological examination showed benign multinodular hyperplasia with epithelioid cell granulomas and giant cells. The histopathological examination of the lung biopsy showed foci of granulomatous inflammation along with caseous necrosis. The diagnosis of tuberculosis involving the lungs and the thyroid gland was established. Then, patient was put on antitubercular drugs with a good recovery.
Conclusion: Although thyroid tuberculosis is a rare condition, it should be considered as differential diagnosis of thyroid masses especially in an endemic country. In this case, the use of fine needle aspiration biopsy can help to avoid unnecessary surgical interventions.
20 - 23 May 2017
European Society of Endocrinology