A rare case of primary tuberculosis in a solitary thyroid nodule

Jie, Sally Chan Shin; Tan, Choon Chieh

doi:10.1016/j.ijtb.2019.08.001

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…These characteristics are not specific and are similar to what is seen regarding the incidence of thyroid disease. PTT is most frequent in the lower right lobe of the thyroid 6,7 and the cases of our study were consistent with this (6/9).…”

Section: Discussionsupporting

confidence: 91%

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

Sun

Dong

et al. 2022

Sao Paulo Med. J.

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BACKGROUND: Primary thyroid tuberculosis (PTT) is an uncommon type of extrapulmonary tuberculosis, which is caused by Mycobacterium tuberculosis. It does not have specific clinical manifestations, and most cases are diagnosed through postoperative histopathological examination. OBJECTIVE: To evaluate the diagnostic pattern and management strategy among patients with primary thyroid tuberculosis. DESIGN AND SETTING: Retrospective study on patients with primary thyroid tuberculosis in the First Hospital of Jilin University (Changchun, China). METHODS: Between March 2015 and June 2020, nine cases of PTT were diagnosed and treated in the Department of Thyroid Surgery of the First Hospital of Jilin University. Age at diagnosis, primary symptoms, preoperative biopsy, operation method, pathological classification, acid-fast staining test, anti-TB therapy and prognosis were registered in order to explore the appropriate protocol for diagnosis and treatment of this disease. RESULTS: None of the patients was diagnosed with thyroid tuberculosis before surgery. All the patients underwent surgery. Granulomatous changes or caseous necrosis in thyroid tissue were found through postoperative histopathological evaluation. Polymerase chain reaction (PCR) results for Mycobacterium tuberculosis were positive in all patients. Most patients had a good prognosis after surgery and anti-tuberculosis drug therapy. CONCLUSION: PTT is a rare disease. It is important to improve the preoperative diagnosis. Preoperative diagnostic accuracy relies on increased awareness of the disease and appropriate use of preoperative diagnostic methods, such as PCR detection, fine-needle aspiration cytology, acid-fast bacillus culture, ultrasound and blood sedimentation. PCR detection of M. tuberculosis is recommended as the gold standard for diagnosis.

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Section: Discussionsupporting

confidence: 91%

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

Sun

Dong

et al. 2022

Sao Paulo Med. J.

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“…Contrary to above mentioned, single solid cystic lesion (16×20 mm) in left lobe with evidence of echogenic contents within and few variable sized isoechoic to hypoechoic solid lesions in bilateral thyroid lobes were present in our case. Computed tomography and MRI are also nonspecific to differentiate malignancy from TTB 13 .…”

Section: Discussionmentioning

confidence: 99%

“…Fine-needle aspirates from tubercular thyroid shows epithelioid granulomas with necrosis. However, the demonstration of acid-fast bacilli and the presence of caseating necrosis are pathognomonic for tuberculous thyroiditis as epitheloid granuloma may be seen in other conditions like granulomatous thyroiditis, fungal infection, sarcoidosis, vasculitis, foreign body reactions, plasma cell neoplasms, and even in anaplastic carcinoma 13 , 15 .…”

Section: Discussionmentioning

confidence: 99%

Primary thyroid tuberculosis mimicking papillary carcinoma of thyroid: a rare case report

Banmala

Sarita

Raut

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and Importance: Primary thyroid tuberculosis is an extremely rare extrapulmonary involvement by the causative agent, Mycobacterium tuberculosis. Its rarity and resemblance to thyroid malignancy led to unnecessary aggressive operative interventions. Case Presentation: A 54-year-old female presented with recent onset dysphagia and foreign body sensation in the throat for 3 months, and anterior neck swelling since last 10 years. Clinical Findings and Investigations: A single nodular firm anterior neck swelling was present which moves with deglutition. Thyroid function test was normal. Ultrasonography thyroid revealed TIRADS-3. Fine-needle aspiration cytology was suggestive of papillary carcinoma of thyroid. Interventions and Outcome: Total thyroidectomy with central compartment neck dissection was performed. Histopathology of the thyroid specimen revealed tubercular thyroiditis. Postoperatively, Mantoux test and interferon gamma radioassay were positive. Antitubercular therapy was given for total of 6 months. Conclusions: With ultrasonography-guided fine-needle aspiration cytology, preoperative diagnosis of primary thyroid tuberculosis is quite challenging even in tuberculosis endemic countries. So, it should be considered one of the differential diagnoses despite negative relevant history and without clinical cervical lymph nodes involvement with cytology proven suspicious papillary thyroid cancer before proceeding for surgical intervention.

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“…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 ].…”

Section: Discussionmentioning

confidence: 99%

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

Akbulut

Demyati

Yavuz

et al. 2022

Annals of Medicine &Amp; Surgery

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A rare case of primary tuberculosis in a solitary thyroid nodule

Cited by 3 publications

References 8 publications

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

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

Primary thyroid tuberculosis mimicking papillary carcinoma of thyroid: a rare case report

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

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