Tuberculosis of the Thyroid

Tuberculosis of the Thyroid-a Diagnostic Enigma

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.

Analysis of misdiagnosis of 4 cases of tuberculosis of thyroid and literature review

Objective. To investigate the cause of misdiagnosis and the diagnosis and treatment of tuberculosis of thyroid. Methods. Four cases of tuberculosis of thyroid were reported and the related literature was reviewed, as well as the causes of misdiagnosis and the diagnosis and treatment were discussed. Results. Two cases were misdiagnosis as thyroid adenoma and one case as thyroid carcinoma, while one case as missed diagnosis. Part of resection, local excision, and lobectomy was performed, respectively, with all the patients who were treated with antituberculosis drugs and recovered. Conclusion. The atypical manifestation of tuberculosis of thyroid suggested that it is important to reinforce the knowledge of this disease. Cytological examination by fine-needle aspirate biopsy was helpful to the diagnosis. The first choice was treatment with anti-tuberculosis drugs.

Tuberculosis of the Thyroid Gland: Review of the Literature

OBJECTIVE

Thyroid tuberculosis (TTB) is a very rare condition, even in countries with a high prevalence of tuberculosis. The aim of this article is to review and retrieve data about thyroid tuberculosis from the English-language literature in order to gain a better understanding of the clinical characteristics of TTB.

STUDY DESIGN

We performed Medline, PubMed, and library searches using the key words "thyroid tuberculosis," "throid disease," "tuberculosis and thyroid." Reference lists of the articles obtained and previous reviews were also examined.

RESULTS

We retrieved 76 cases matching our selection criteria from the search. Review of the cases with TTB revealed a slight female preponderance. The patients reported in the literature ranged in age from 9 to 83 years, with a median age of 40+/-16 years for men and 44+/-17 years for women. In the articles surveyed, TTB presented with a broad spectrum of manifestations, ranging from an isolated nodule to thyrotoxicosis. It seems that diagnosis of thyroid tuberculosis has recently been increasing, perhaps because of the growing incidence of tuberculosis and the diagnostic use of fine-needle aspiration cytology in the diagnosis. Although, in the past, the diagnosis was generally made by the examination of the specimens, at present, fine-needle aspiration cytology seems to be a useful method in diagnosis tuberculous thyroiditis. The role of surgery is limited after the diagnosis. The choice of treatment should be medical antituberculous therapy.

CONCLUSIONS

Preoperative diagnosis of thyroid tuberculosis is important because of the availability of medical treatment and the limited role of surgery. This condition should be kept in mind in evaluating patients with a thyroid nodule, in communities where the prevalence of tuberculosis is high.

[Thyroid tuberculosis]

OBJECTIVES

The aims of this study were to emphasize the difficulties of diagnosing thyroid tuberculosis because of its non specific symptoms and to encourage physicians to seek it more frequently.

MATERIAL AND METHODS

Six cases of thyroid tuberculosis diagnosed within a 3-year period were included in a retrospective study.

RESULTS

There were two men and four women, mean age 45 years. Four patients underwent lobo-isthmectomy with frozen section analysis which enabled us to rectify the diagnosis. Medical treatment was based on a 6-month course of bactericidal chemotherapy. Outcome was favorable in all the cases with 17 months average follow up.

CONCLUSION

Symptoms of thyroid tuberculosis are misleading, pathologic findings are of increasing importance for diagnosis, which with the new serology techniques may improve further.