Amyloidosis of the thyroid gland: Role of ultrasonography

El-Reshaid, Kamel; Al-Tamami, Mohi Al-Tamami; Johny, K.V.; Madda, John Patrick; Hakim, A.

doi:10.1002/jcu.1870220405

Cited by 19 publications

(5 citation statements)

References 8 publications

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“…T-99 pyrophosphate, ultrasound computed tomography, and magnetic resonance imaging studies are nonspecific (12). Hyperechoic feature and fine homogeneous texture of the goiter have been described at ultrasound examination (13). Fine-needle aspiration biopsy may facilitate the diagnosis of amyloid goiter (14,15), however amyloid deposition in the thyroid is not limited to amyloid goiter and is seen in association with medullary carcinoma and plasma cell dyscrasias.…”

Section: Discussionmentioning

confidence: 97%

Amyloid Goiter as the Initial Manifestation of Systemic Amyloidosis due to Familial Mediterranean Fever with Homozygous MEFV Mutation

Sbaï

Wechsler²,

Leenhardt³

et al. 2001

Thyroid

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We describe a case of amyloid goiter revealing a systemic amyloidosis secondary to familial Mediterranean fever (FMF) with homozygous MEFV mutation, and we review the literature. A 45-year-old euthyroid Sephardic man, known to suffer from FMF, developed a goiter with cold nodule, after which a subtotal thyroidectomy was performed. Histologic evaluation revealed diffuse AA amyloid deposition without any associated thyroid neoplasia. At that time, no other organ was found to be affected by amyloidosis. Colchicine and levothyroxine were prescribed. Eight years later, the patient presented with a rapidly growing neck enlargement. He reported that he had discontinued colchicine therapy 2 years earlier. The serum thyrotropin (TSH) and calcitonin levels were normal. Renal, digestive, and salivary gland biopsies confirmed the presence of systemic AA amyloidosis. Despite the reintroduction of colchicine, the onset of compressive symptoms led to the completion of the total thyroidectomy. The histopathology again demonstrated amyloid deposition, and excluded a malignant neoplasm. Nine cases of amyloid goiter associated with FMF have been reported in the literature; none of them had an amyloid goiter as the first manifestation of systemic amyloidosis. To our knowledge, this is the first case of FMF in which an amyloid goiter preceded the development of secondary systemic amyloidosis. The cessation of colchicine therapy may have played a role in local relapse and the secondary spread of amyloid deposits.

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Section: Discussionmentioning

confidence: 97%

Amyloid Goiter as the Initial Manifestation of Systemic Amyloidosis due to Familial Mediterranean Fever with Homozygous MEFV Mutation

Sbaï

Wechsler²,

Leenhardt³

et al. 2001

Thyroid

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“…Our sonographic findings of increased reflectivity and altered echotexture are compatible with the ground-glass appearance described by el-Reshaid et al . 10 The cysts, though lobular, were simple in appearance without the internal components as reported by Fontan et al . 11…”

Section: Discussionmentioning

confidence: 59%

“…At ultrasound, in addition to uni- or bi-lobar thyroid enlargement, many report a marked increase in thyroid reflectivity approaching that of the surrounding connective tissue, 3, 5 as a result of fatty infiltration within the thyroid. 9 A very fine homogeneous echotexture similar to ground glass appearance 10 has also been described, whereas focal areas of reduced reflectivity are seen with more localized amyloid deposits.…”

Section: Discussionmentioning

confidence: 88%

Primary Amyloid Goiter and Review of Imaging Characteristics

Chung

Pilcher

2013

Ultrasound

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Clinically symptomatic amyloid goiter is extremely rare. We report the case of a 76-year-old male patient under the care of the nephrologists with end stage renal failure of unknown aetiology. Concurrent investigation for a dysphagia causing goiter allowed primary diagnosis of amyloid by targeted fine needle aspiration (FNA) under ultrasound guidance. The imaging features are reviewed across multimodalities. This report highlights the usefulness of FNA in establishing diagnosis and the importance of maintaining clinical suspicion in patients with a concomitant history of a chronic inflammatory process.

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“…In the present case, neither hemorrhage nor cyst nor fatty infiltration were seen in the histological examination of wedge resection biopsy of the thyroid gland. El-Reshaid et al (1994) reported a high echogenicity of a very fine homogenous echotexture in 3 cases with diffuse amyloid goiter. The utrasound findings in the present case were similar to these.…”

Section: Discussionmentioning

confidence: 97%

Amyloid Goiter: Radiological Study in a Case Presenting Hypothyroidism

Ishimura¹,

Okamura²,

Masaki³

et al. 1996

Horm Metab Res

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We report herein a case of amyloid goiter associated with rheumatoid arthritis in which hypothyroidism was observed. A 52-year-old housewife who had suffeed from rheumatoid arthritis for 15 years was referred to our hospital because of general fatigue. On admission, a large goiter was observed. Laboratory data showed primary hypothyroidism. Renal biopsy and gastric mucosa biopsy showed amyloid deposition of AA-type. Thyroid biopsy showed massive amyloid involvement. Although the findings of iodine-123 scintigraphy, technetium-99m pertechnetate scintigraphy, computed tomography and magnetic resonance image studies were similar to those for goiter associated with chronic thyroiditis, tallium-201 chloride scintigraphy gave a differing result, demonstrating absent uptake at 3 hours in this case. Replacement therapy with levothyroxine relieved the symptoms. This case was unusual in that amyloid goiter presented clinically as hypothyroidism. Absence of tallium-201 chloride uptake at 3 hours may be a diagnostic specificity for amyloid goiter in differentiating its hypothyroidism from that caused by chronic thyroiditis.

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Amyloidosis of the thyroid gland: Role of ultrasonography

Cited by 19 publications

References 8 publications

Amyloid Goiter as the Initial Manifestation of Systemic Amyloidosis due to Familial Mediterranean Fever with Homozygous MEFV Mutation

Amyloid Goiter as the Initial Manifestation of Systemic Amyloidosis due to Familial Mediterranean Fever with Homozygous MEFV Mutation

Primary Amyloid Goiter and Review of Imaging Characteristics

Amyloid Goiter: Radiological Study in a Case Presenting Hypothyroidism

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