Thyroid Tuberculosis: Diagnosis and Treatment

Abstract

Objective: It was the aim of this study to report clinical characteristics and treatment of thyroid tuberculosis (TT). Methods: During 16 years, 2,426 patients have been operated on the thyroid in the surgical department ‘A’ in Ibn Sina Hospital, Rabat, Morocco. Anatomopathological results of the removed thyroid were analyzed for evidence of tuberculosis. Results: Eight cases of TT were diagnosed. Five patients had a goiter and 3 patients had an isolated nodule of the thyroid. In one case, fine-needle aspiration cytology gave the diagnosis of TT. This patient had a complete drainage of the abscess. In all other patients, the diagnosis was given after surgery. All patients received additional antituberculous drugs for 6 months, and follow-up was satisfactory. Conclusion: TT does not have any consistent symptoms. Fine-needle aspiration is the best method for diagnosis and can result in the avoidance of surgery.

Primary tuberculosis of the thyroid gland

“…[24][25][26] The diagnosis is mainly made by ultrasound guided fine-needle aspiration cytology, a diagnostic step that helps to avoid unnecessary surgery. 4,27,28 In most cases definite diagnosis is made post-operatively by means of histopathological examination of the surgical specimen, as in our patient. 4,5,14 Since granulomatous lesions are not pathognomonic of tuberculosis, as they may be seen in sarcoidosis and subacute thyroiditis, the caseating necrosis, if present, confirms the diagnosis of tuberculosis.…”

“…4,27,28 In most cases definite diagnosis is made post-operatively by means of histopathological examination of the surgical specimen, as in our patient. 4,5,14 Since granulomatous lesions are not pathognomonic of tuberculosis, as they may be seen in sarcoidosis and subacute thyroiditis, the caseating necrosis, if present, confirms the diagnosis of tuberculosis. In our case, the tuberculous origin of the thyroid disease was confirmed by the presence of caseaum in the lymph node.…”

“…1,[3][4][5] However, at least 200 cases have been recorded in the English language literature since the first case reported by Leber. [6][7][8][9][10][11] The reason for the rarity of thyroid TB is unknown.…”

“…4,5,27 For some authors drugs alone are sufficient. 30 In our patient, although surgery was applied for the purpose of diagnosis, the affected lobe was also resected.…”

Tubercular thyroid abscess: A case report

“…Antitubercular therapy is the preferred method of treatment of tuberculosis of thyroid nowadays [20]. If thick pus is present in central part it can be aspirated using thick needle.…”