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Riedel's Thyroiditis in a Patient with Recurrent Subacute Thyroiditis:
A Case Report and Review of the Literature.Endocr
J. 2007 Sep;54(4):559-62.
Riedel's
thyroiditis is a rare form of chronic thyroiditis, characterised by a
fibroinflammatory process that partially destroys the thyroid and
often involves surrounding tissues. The relationship of Riedel's
thyroiditis to other forms of thyroiditis is not clear. A case of
Riedel's thyroiditis in a 51-year-old woman presenting with symptoms
of subacute thyroiditis, is reported. She was diagnosed with subacute
thyroiditis based on clinical manifestation and laboratory results.
She was treated with glucocorticoids for six weeks, and then
followed-up for 12 months. Three years later, she visited with
tenderness and enlargement of thyroid mass, and laboratory and
radiology findings suggested that she had a malignant thyroid tumor as
well as subacute thyroiditis. After thyroidectomy, histopathologic
findings showed that she had Riedel's thyroiditis in the presence of
subacute thyroiditis. Until now, few cases of Riedel's thyroiditis in
patients with a history of subacute thyroiditis have been reported in
the literature. Although the etiology of Riedel's thyroiditis is
unknown, it may develop in the course of subacute thyroiditis.
Riedel's
thyroiditis. Personal experience.G
Chir. 2006 Apr;27(4):165-8.
The Riedel's
thyroiditis, also called "wood's thyroiditis", is a rare chronic
"inflammatory" disease of unknown etiology, relatively frequent in
female >45-50 years, characterized by a fibrotic process that pervades
thyroid and neighbouring structures (vessels, muscles, oesophagus,
trachea upper- mediastinum). The authors discuss about three cases of
Riedel's thyroiditis and report the outcome after total thyroidectomy
in two cases and sub-total resection in the other one.
An unusual form of
Riedel's thyroiditis: a case report and review of the literature.Thyroid.
2005 Jan;15(1):85-8
We report the
case of a 36-year old woman with a history of long-term fever
associated with a biologic inflammatory syndrome that was not
corrected by several courses of corticosteroid treatment. The only
remarkable result during previous investigations was the presence of a
positive Epstein-Barr virus (EBV) serology. Clinical examination
revealed an heterogenous thyroid with a nodule on the right lobe.
Serum thyrotropin (TSH) concentration was normal. The levels of
antiperoxidase antibodies and thyrocalcitonin were normal. Ultrasound
examination of the neck showed a 3-cm hypoechogenous nodule in the
right lobe of the thyroid. A total thyroidectomy was performed.
Histopathologic findings led to the diagnosis of Riedel's thyroiditis.
We observed a dramatic improvement after surgery with absence of fever
and normalization of inflammatory parameters. The role of EBV
infection in the process of this unusual form of Riedel's thyroiditis
is discussed.
Fine-needle
aspiration of Riedel's disease: report of a case and review of the
literature.Diagn
Cytopathol. 2004 Mar;30(3):193-7.
The
cytomorphological features of a case of Riedel's thyroiditis (Riedel's
disease) in a 37-yr-old woman are reviewed. The patient presented with
a diffusely enlarged thyroid gland with extension to carotid and
jugular vessels bilaterally. A fine-needle aspiration of the right
lobe of the thyroid demonstrated moderate cellularity with fragments
of fibrous tissue with bland spindle-shaped cells and myofibroblasts.
The patient subsequently underwent a bilateral subtotal thyroidectomy
with removal of two-thirds of both lobes of the thyroid. A frozen
section diagnosis of Riedel's disease was later confirmed on paraffin
sections. Here we describe the cytological findings of a case of
Riedel's disease and provide some helpful clues in distinguishing it
from other forms of thyroiditis such as fibrosing variant of
Hashimoto's thyroiditis, subacute thyroiditis, or granulomatous
thyroiditis and from malignancy with which it can be confused both
clinically and cytologically.
Riedel's
thyroiditis: clinical, pathological and imaging features.Int
J Clin Pract. 2002 Jan-Feb;56(1):65-7.
Riedel's
thyroiditis (RT) is an extremely rare form of chronic thyroiditis,
characterised by a fibroinflammatory process which partially destroys
the thyroid, often involving surrounding tissues. We describe an
unusual case of RT in a 38-year-old woman, and discuss its typical
clinical, pathological, ultrasound, radionuclide scanning and magnetic
resonance findings. We conclude that the diagnosis of RT is highly
suggestive in the presence of a hard gland (or nodule), fixed to
adjacent structures; 'cold' on Tc99 scan; hypoechoic with absence of
vascular flow, invading the adjacent neck structures on ultrasound;
hypointense in T1- and T2-weighted MR images; and showing fibrous
tissue fragments with inflammatory cells at cytological examination.
Thyroidectomy has to be performed to confirm the diagnosis and to
relieve pressure symptoms.
Riedel's thyroiditis: an autoimmune or primary fibrotic disease?
J Intern Med 1994 Mar;235(3):271-4.
Riedel's
thyroiditis is a rare condition with an unknown aetiology. The
condition was discovered by Riedel in 1883. In 1904, Hashimoto
described another condition of invasive fibrous thyroiditis. Since
then it has been discussed whether Hashimoto's thyroiditis and
Riedel's thyroiditis are one disease in different states or whether
they are two different diseases. Hashimoto's thyroiditis is known to
have an autoimmune aetiology and can be seen in conjunction with other
autoimmune diseases such as pernicious anaemia. The co-existence of
Riedel's thyroiditis and pernicious anaemia is reported for the first
time in this case story. Our patient was initially treated with a high
dose of steroids and today is well on low-dose steroids and without
relapse. The co-existence mentioned, the good effect of steroid
treatment, the frequent presence of thyroid autoantibodies and
lymphoid infiltration of the thyroid gland resembling that of
Hashimoto's thyroiditis might indicate an autoimmune aetiology. It may
be that the action on fibroblasts of cytokines known to be released by
infiltrating lymphocytes constitutes a possible fibrogenic mechanism,
but the primary lesion is still unknown.
Riedel's
thyroiditis.
Am J Clin Pathol. 1988 Dec;90(6):715-22.
Riedel's
thyroiditis is a rare chronic inflammatory disease of the thyroid
gland first recognized by Bernhard Riedel in 1893. In order to clarify
the clinical and pathologic features of this rare disorder, a recent
case of Riedel's thyroiditis is presented, 6 additional cases from the
surgical pathology files of the Cleveland Clinic Foundation are
reported, and the 178 cases previously reported in the English
literature are reviewed. The mean age at presentation has been 47.8
years, and 83% of patients have been female. Sixty-four percent were
euthyroid, 32% hypothyroid, and 4% hyperthyroid. Antithyroid
antibodies have been detected in 16 of the 25 patients tested. Since
1960, 34% of the published cases of Riedel's thyroiditis have reported
the development of multifocal fibrosis. Immunohistologic study of the
inflammatory infiltrate reveals a mixed population of B- and T-cells.
Comparison with the infiltrate in Hashimoto's thyroiditis shows
similar proportions of CD4- and CD8-positive lymphocytes. The
relationship and origin of multifocal fibrosing lesions has not been
defined, but an immunologic origin seems most likely. The finding of
antithyroid antibodies in 67% of patients supports an autoimmune
mechanism of injury. |
