Advertisement

Thyroid tuberculosis diagnosed as papillary thyroid carcinoma with fever of unknown origin

Published:October 14, 2021DOI:https://doi.org/10.1016/j.anl.2021.09.008

      Abstract

      Thyroid tuberculosis is a rare disease, very few cases have been reported. It is difficult to diagnose because of no typical characteristics. We report on a patient who underwent surgery for suspected thyroid carcinoma, but who was then diagnosed with thyroid tuberculosis. The patient was a woman in her 70s. She had been diagnosed with chronic renal failure and had been on peritoneal dialysis. She complained of fever and a painful left anterior neck swelling. Computed tomography showed thyroid tumor with cervical lymph node swelling, ultrasound-guided fine needle aspiration cytology was suspected for papillary thyroid carcinoma. We performed surgery to confirm the diagnosis and determine treatment. Procedures for thyroid carcinoma were followed, including left lobectomy of the thyroid gland, central lymph node dissection and right cervical lymph node resection. Pathological examination found no malignant findings in the thyroid tissue but did find a granulation layer even in the right cervical lymph node. Tuberculosis-specific IFN-γ assay was positive, we diagnosed thyroid and cervical lymph node tuberculosis. Postoperatively, the neck pain and fever improved, she was treated as an outpatient with antituberculosis drugs therapy. Thyroid tuberculosis must be considered in patients with immunocompromised, such as this patient, who was on peritoneal dialysis.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Auris Nasus Larynx
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Global tuberculosis report 2020. World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/336069/9789240013131-eng.pdf [accessed 21 April 2021]

        • Bulbuloglu E
        • Ciralik H
        • Okur E
        • Ozdemir G
        • Ezberci F
        • Cetinkaya A.
        Tuberculosis of the thyroid gland: review of the literature.
        World J Surg. 2006; 30: 149-155
        • Laitman BM
        • Samankan S
        • Hwang S
        • Chai RL.
        Primary thyroid tuberculosis: an uncommon presentation of a thyroid mass.
        Ear Nose Throat J. 2020; 14145561320949481
      2. The tuberculosis surveillance center: statistics of TB in Japan 2019. Tokyo. https://www.jata.or.jp/rit/ekigaku/toukei/nenpou/ [accessed 23 April 2021]

        • Kulchavenya E.
        Extrapulmonary tuberculosis: are statistical reports accurate?.
        Ther Adv Infect Dis. 2004; 2: 61-70
        • Takami H
        • Kozakai M.
        Tuberculous thyroiditis: report of a case with a review of the literature.
        Endocr J. 1994; 41: 743-747
        • Asayama I
        • Ishikawa T
        • Yamada T
        • Kitagawa W
        • Shimizu K.
        A case of tuberculous granuloma at the supra-sternal notch that was difficult to differentiate from a thyroid tumor.
        Med Sci Monit. 2004; 10: 37-40
        • Lourtet-Hascoet J
        • Le Grusse J
        • Fontaine S
        • Caron P
        Thyroid tuberculosis: a new case and review of the literature.
        Ann Endocrinol (Paris). 2015; 76: 635-637
        • Al-Efraij K
        • Mota L
        • Lunny C
        • Schachter M
        • Cook V
        • Johnston J.
        Risk of active tuberculosis in chronic kidney disease: a systematic review and meta-analysis.
        Int J Tuberc Lung Dis. 2015; 19: 1493-1499
        • Arai J
        • Kitamura K
        • Yamamiya A
        • Ishii Y
        • Nomoto T
        • Honma T
        • et al.
        Peripancreatic tuberculous lymphadenitis diagnosed via endoscopic ultrasound-guided fine-needle aspiration and polymerase chain reaction.
        Intern Med. 2017; 56: 1049-1052
        • Gupta N
        • Sharma K
        • Barwad A
        • Sharma M
        • Rajwanshi A
        • Dutta P
        • et al.
        Thyroid tuberculosis - role of PCR in diagnosis of a rare entity.
        Cytopathology. 2011; 22: 392-396
        • Al-Mulhim AA
        • Zakaria HM
        • Abdel Hadi MS
        • Al-Mulhim FA
        • Al-Tamimi DM
        • Wosornu L
        Thyroid tuberculosis mimicking carcinoma: report of two cases.
        Surg Today. 2002; 32: 1064-1067
        • Hsiao YC
        • Wu PS
        • Chiu NT
        • Yao WJ
        • Lee BF
        • Peng SL.
        The use of dual-phase 18F-FDG PET in characterizing thyroid incidentalomas.
        Clin Radiol. 2011; 66: 1197-1202
        • Bomanji J
        • Sharma R
        • Mittal BR
        • Gambhir S
        • Qureshy A
        • Begum SMF
        • et al.
        Sequential 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) scan findings in patients with extrapulmonary tuberculosis during the course of treatment-a prospective observational study.
        Eur J Nucl Med Mol Imaging. 2020; 47: 3118-3129