Tuberculosis of the Thyroid Gland Presented as a Rapid Enlargement of a Preexisting Goiter

Abstract

Thyroid involvement with tuberculosis is an uncommon condition even in endemic countries. As its clinical presentation is not specific, diagnosis is often difficult and requires histopathological confirmation. Herein we report an observation of secondary tuberculosis of the thyroid gland in a woman with a type 2 diabetes mellitus and a primary hypothyroidism. She presented with a rapid enlargement of a preexisting goiter without compressive symptoms. The imaging exams showed a voluminous plunging multinodular thyroid gland and multiple bilateral lung nodules. Malignancy was suspected and the patient underwent a total thyroidectomy and a lung biopsy. Histopathological examination revealed multiple tuberculous foci involving both the thyroid gland and the lungs.

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

“…Tuberculous nodules are often accompanied by thyroid adenoma, diffuse goiter, acute abscess and cervical lymph node lesions, and are sometimes manifested as sudden enlargement of the original thyroid nodules. 8 Some cases are accompanied by neck compression symptoms. 9 In a few cases, thyroid damage has been found to be caused by M. tuberculosis or even by thyrotoxicosis or mucoedema.…”

Coexistence of tuberculosis and extranodal marginal zone lymphoma of the thyroid gland: Case report and literature review

“…The most frequent clinical presentation is a solitary thyroid nodule that may present as a cystic nodule [ 18 ]. It may also present as diffuse multinodular swelling, rapid enlargement of a preexisting goiter, thyroid abscess with pain, fever, and other non-specific signs and symptoms [ [18] , [19] , [20] ]. Fine needle aspiration cytology finding of granulomatous inflammation suggests the diagnosis, and the sample is considered diagnostic when Ziehl-Neelsen stain and AFB culture are positive [ 21 ].…”

Hypothyroidism and multinodular goiter due to tubercular thyroiditis: A rare coexistence

“…Treatment of tuberculosis of the thyroid gland is based on anti-tuberculosis drugs and/or surgery. Previously the management was based on medical treatment combined with surgical drainage and resection of the affected parts, so nowadays antituberculosis drugs considered as the first line treatment modality that can be sufficient without recourse to surgery [ 2 , 6 ].…”