Images in Surgery| Volume 147, ISSUE 3, P461-462, March 2010

Atypical subacute thyroiditis

Published:December 01, 2008DOI:
      A 38-year-old woman presented with a 3-week history of a painless lump in her neck. She denied history of trauma, fever, radiation exposure, or a preceding upper respiratory tract infection. Her family history was significant in that her mother had benign nodular goiter. The patient was otherwise in good health. On palpation, the right lobe was enlarged and firm with minimal tenderness. Thyroid function was within normal limits. Thyroid ultrasound showed a 1.5 × 1.1-cm hypoechoic mass at the right lobe, with an irregular and poorly defined border. No cervical lymphadenopathy was detected. Fine-needle aspiration cytology was insufficient for diagnosis. Based on suspicious ultrasonographic characteristics, a right lobectomy was performed (Fig 1). Histopathologic examination showed a mixed inflammatory infiltrate with some multinucleate giant cells (Fig 2). She is euthyroid without recurrence after 2 years of follow-up.
      Figure thumbnail gr1
      Fig 1Photograph showing the gross appearance of the cut surface of the thyroid tumor. The yellow-white lesion has an irregular margin.
      Figure thumbnail gr2
      Fig 2Photomicrograph (hematoxylin-eosin, original magnification × 100) showing chronic inflammation and prominent fibrosis with some multinucleated giant cells. There is no caseous necrosis. Residual follicles are present.
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