|
Subacute thyroiditis in a single lobe.
Clin Nucl Med. 2001 May;26(5):400-1.
A 33-year-old
woman with no history of thyroid disease reported pain in her neck and
a sore throat. On physical examination, the thyroid gland was
palpable. Serum T3 and T4 levels were increased, and the
thyroid-stimulating hormone level was decreased. Thyroid scintigraphy
with Tc-99m pertechnetate revealed nonvisualization of the left lobe
of the thyroid. Ultrasonographic examination confirmed the presence of
the left thyroid lobe. Fine-needle aspiration biopsy revealed
thyroiditis of the left lobe of the thyroid. The patient was started
on an anti-inflammatory drug. The follow-up thyroid scan showed
a normal thyroid gland.
De
Quervain's subacute thyroiditis presenting as a painless solitary
thyroid nodule.Postgrad
Med J.1998 Oct;74(876):602-3.
We describe a
39-year-old woman presenting with a painless solitary thyroid nodule,
initially without signs suggesting thyroiditis. The serum level
of thyrotropin was suppressed whereas those of thyroxine and
triiodothyronine were normal. Fine needle aspiration cytology showed
no signs of inflammation or malignancy. One week later, the patient
felt pain and tenderness on her neck, and erythrocyte sedimentation
rate and C-reactive protein were markedly elevated. Thyroid
scintigraphy showed a suppressed thyroid pertechnetate uptake. At that
time, the diagnosis of subacute thyroiditis was made. Upon
treatment with steroids the patient's symptoms as well as the
thyroid nodule resolved. This case illustrates that subacute
thyroiditis de Quervain may present as a solitary, painless
nodule with suppressed thyrotropin and should therefore be considered
in the differential diagnosis of such lesions.
Fine needle
aspiration cytodiagnosis of subacute (de Quervain's) thyroiditis in an
endemic goitre area.Cytopathology.
1994 Feb;5(1):33-40..
Between 1977 and
1989 252 fine needle aspirates (FNAs) of the thyroid from patients
with a clinical suspicion of subacute granulomatous (de Quervain's)
thyroiditis were examined in the Department of Pathology of the
University of Innsbruck, Austria. In the same period 31 cases with
preoperative FNA were diagnosed histologically as subacute thyroiditis.
Only in three of these cases were the cytological features of de
Quervain's thyroiditis found in the preoperative FNA. However, in 13
of these 31 cases a cytological suspicion of malignancy was obtained.
Subsequent histological examination revealed an acute phase
inflammation of de Quervain's thyroiditis in most of these cases. We
conclude that an accurate FNA diagnosis of de Quervain's thyroiditis,
particularly in the acute stage, may cause difficulties due to a lack
of typical features and the appearance of atypical thyroid follicular
cells. For the cytopathologist, accurate clinical information relating
to the possibility of de Quervain's thyroiditis is essential if
unnecessary surgery is to be avoided.
Painful subacute thyroiditis (de Quervain's
thyroiditis.J
Natl Med Assoc. 1992 Oct;84(10):877-9.
Painful subacute
thyroiditis (de Quervain's thyroiditis) usually occurs in association
with systemic viral illnesses. This disorder may be manifested in
various clinical forms. Primary care physicians must be aware of the
clinical features of this disorder to make the correct diagnosis and
treat appropriately. Three cases are reported to illustrate the
different clinical manifestations of this disorder.
Occurrence of
fibrosis in subacute de Quervain thyroiditis.Schweiz
Med Wochenschr. 1986 Aug 16;116(33):1093-7.
Subacute
thyroiditis of de Quervain is histologically characterized by an
inflammatory reaction with histiocytes and giant cells around residues
of colloid, producing a tubercle-like granulomatous picture. A
variable degree of fibrosis occurs, but recovery is generally almost
complete. Investigation of a series of thyroid glands with de
Quervain's thyroiditis gave the impression of rather extensive and
increasing fibrosis in most of these glands. To substantiate this
impression we reviewed the histological slides of all our cases of de
Quervain's thyroiditis diagnosed at the Department of Pathology of the
University of Zurich between 1940-1950 and 1974-1984. In the majority
of the glands of both periods we found rather extensive fibrosis
involving more than 50% of the surface. In young patients the fibrosis
seemed to be more extensive than in older subjects. There was no sex
difference. A certain degree of fibrosis appears to be characteristic
of de Quervain's thyroiditis. Differences of frequency and degree of
fibrosis between the two periods could not be demonstrated.
De Quervain's
subacute granulomatous thyroiditis: histological identification and
incidence.J
Clin Pathol. 1963
May;16:189-99
The histological
features of de Quervain's subacute granulomatous thyroiditis are
described, on the basis of a study of six specimens. This condition,
unlike Hashimoto's disease, rarely causes permanent hypothyroidism;
its histological identification is thus of practical importance. Areas
of thyroid affected by the disease show intrafollicular cellular
infiltration, with partial or complete loss of colloid from
infiltrated follicles, partial or complete disruption of their lining
epithelium, and abnormalities of the basement membrane. These changes
tend eventually to lead to replacement of the damaged follicle by a
granuloma-like structure devoid of colloid content and without a
recognizable epithelial lining. The disease also causes
interfollicular fibrosis and an interstitial inflammatory cell
reaction. The histological pattern is typically multiform. Formative
follicle lesions present a striking appearance, aiding recognition of
the disease. Some follicles contain numerous giant cells, often
grouped around a central pool of residual colloid; others may contain
a considerable proportion of neutrophil polymorphs or show radially
aligned spindle-shaped cells.A study has also been made of the
incidence of de Quervain's thyroiditis in surgical material in
Sheffield during the seven year period 1955-61. Only two examples were
found in a total of 1,282 cases of primary thyroid disease, an
incidence of 1.6 per 1,000 (0.16%); there is, however, reason to
believe that the overall clinical incidence is higher than that
indicated by the surgical figures.
The pathology of granulomatous diseases of the thyroid
gland.Sarcoidosis.
1990 Mar;7(1):19-27.
In the present
review we comment on granulomatous diseases of the thyroid gland based
mainly on combined clinico-pathological criteria. Emphasis is given to
diseases restricted to the thyroid (i.e., de Quervain's, palpation and
interstitial giant cell thyroiditis), and those that may manifest as
primary in the thyroid though they may be part of a generalized
process (i.e., sarcoidal, tuberculous, fungal and syphilitic
thyroiditis). Other disorders with minor variable granulomatous or
pseudogranulomatous components affecting the thyroid are briefly
described, and differential diagnoses analysed for granulomatous
lesions both specific and non-specific to the thyroid.
|
