Tuberculosis of the Thyroid—a Diagnostic Enigma

Abstract

Thyroid tuberculosis is very uncommon even in countries where tuberculosis is endemic. It is commonly seen secondary to tubercular infection of other organ or tissue by hematogenous spread. There are many different presentations of thyroid tuberculosis. Before the advent of fine needle aspiration cytology (FNAC), all patients had surgery and thyroid tuberculosis was diagnosed only on biopsy of specimen. Nowadays, FNAC can confirm the diagnosis in many cases, and the patient can be cured by standard anti-tubercular treatment without the need for surgery. Surgery is required only when there is suspicion of malignancy and FNAC is inconclusive.

Acute thyroid swelling in renal transplant recipient

“…More common is miliary spread to thyroid gland as part of the generalized dissemination or, less commonly, focal caseous TB presenting as a thyroid nodule mimicking carcinoma or in late stages forming a cold abscess. [ 10 ] Five patterns have been described: multiple lesions associated with miliary TB, goiter with caseation, cold abscess formation, chronic fibrosing TB, and acute abscess. [ 11 ] Our patient presented with an acute abscess.…”

Metastatic endophthalmitis and thyroid abscess complicating Klebsiella pneumoniae liver abscess

“…Metastatic thyroid abscess is a rare complication because the thyroid gland is resistant to infection due to its encapsulation, iodine concentration, rich lymphatic drainage and dual blood supply [ 14 ]. Reviews of thyroid abscess document a predisposing congenital variant and immunocompromised status with atypical pathogens [ 15 - 17 ]. While thyroid abscesses are uncommon, they are associated with significant risk of rapid progression and potential compromise of the airway, so prompt recognition and treatment are essential for improved patient outcomes.…”