Tuberculosis of the thyroid gland: A rare case report
Tuberculosis (TB) of the thyroid gland is exceedingly rare, even in regions like India, where tuberculosis is prevalent, with an estimated incidence of 0.1–0.4%. While tuberculosis can affect various organs, its involvement in the thyroid, pancreas, striated, and cardiac muscle is uncommon. Diagnosi...
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Wolters Kluwer Medknow Publications
2024-04-01
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| Series: | MGM Journal of Medical Sciences |
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| Online Access: | https://doi.org/10.4103/mgmj.mgmj_239_23 |
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| author | Manisha Kamlesh Galani Kamlesh Jamnadas Galani Swati Nileshkumar Lakhani |
| author_facet | Manisha Kamlesh Galani Kamlesh Jamnadas Galani Swati Nileshkumar Lakhani |
| author_sort | Manisha Kamlesh Galani |
| collection | DOAJ |
| description | Tuberculosis (TB) of the thyroid gland is exceedingly rare, even in regions like India, where tuberculosis is prevalent, with an estimated incidence of 0.1–0.4%. While tuberculosis can affect various organs, its involvement in the thyroid, pancreas, striated, and cardiac muscle is uncommon. Diagnosis poses a challenge due to the lack of distinctive clinical features—microscopic examination revealing epithelioid granulomas, sometimes with caseous necrosis and Langhans-type giant cells, aids in diagnosis. Confirmation typically involves detecting acid-fast bacilli through staining techniques like Ziehl Neelsen (ZN), molecular diagnostic methods such as TB Gene Expert or polymerase chain reaction for Mycobacterium tuberculosis (TB PCR), and histopathological examination of excised specimens. Recently, we encountered a case involving a 21-year-old male presenting with a 2-month history of diffuse neck swelling. Clinical examination suggested thyroid swelling, confirmed by ultrasound, showing a cystic lesion with necrotic areas, suggestive of thyroiditis, accompanied by bilateral cervical lymphadenopathy. Fine Needle Aspiration Cytology revealed necrotizing granulomatous thyroiditis, prompting further investigation for tuberculosis. TB Gene Expert and ZN staining performed on fine needle aspiration cytology (FNAC) material confirmed tuberculosis, leading to anti-tuberculous treatment, which resulted in a positive response. In presenting this case, we aim to highlight the rarity of tuberculosis affecting the thyroid gland and emphasize the importance of considering minimally invasive diagnostic methods, such as FNAC and molecular techniques, before resorting to surgical interventions. This case underscores the significance of clinicians’ awareness regarding unusual tuberculosis presentations and the availability of advanced diagnostic tools to ensure timely and appropriate management. |
| format | Article |
| id | doaj-art-31f6a762a9a1486097b72b34988846de |
| institution | Kabale University |
| issn | 2347-7946 2347-7962 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | Wolters Kluwer Medknow Publications |
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| series | MGM Journal of Medical Sciences |
| spelling | doaj-art-31f6a762a9a1486097b72b34988846de2025-01-25T10:19:23ZengWolters Kluwer Medknow PublicationsMGM Journal of Medical Sciences2347-79462347-79622024-04-0111238338510.4103/mgmj.mgmj_239_23Tuberculosis of the thyroid gland: A rare case reportManisha Kamlesh GalaniKamlesh Jamnadas GalaniSwati Nileshkumar LakhaniTuberculosis (TB) of the thyroid gland is exceedingly rare, even in regions like India, where tuberculosis is prevalent, with an estimated incidence of 0.1–0.4%. While tuberculosis can affect various organs, its involvement in the thyroid, pancreas, striated, and cardiac muscle is uncommon. Diagnosis poses a challenge due to the lack of distinctive clinical features—microscopic examination revealing epithelioid granulomas, sometimes with caseous necrosis and Langhans-type giant cells, aids in diagnosis. Confirmation typically involves detecting acid-fast bacilli through staining techniques like Ziehl Neelsen (ZN), molecular diagnostic methods such as TB Gene Expert or polymerase chain reaction for Mycobacterium tuberculosis (TB PCR), and histopathological examination of excised specimens. Recently, we encountered a case involving a 21-year-old male presenting with a 2-month history of diffuse neck swelling. Clinical examination suggested thyroid swelling, confirmed by ultrasound, showing a cystic lesion with necrotic areas, suggestive of thyroiditis, accompanied by bilateral cervical lymphadenopathy. Fine Needle Aspiration Cytology revealed necrotizing granulomatous thyroiditis, prompting further investigation for tuberculosis. TB Gene Expert and ZN staining performed on fine needle aspiration cytology (FNAC) material confirmed tuberculosis, leading to anti-tuberculous treatment, which resulted in a positive response. In presenting this case, we aim to highlight the rarity of tuberculosis affecting the thyroid gland and emphasize the importance of considering minimally invasive diagnostic methods, such as FNAC and molecular techniques, before resorting to surgical interventions. This case underscores the significance of clinicians’ awareness regarding unusual tuberculosis presentations and the availability of advanced diagnostic tools to ensure timely and appropriate management.https://doi.org/10.4103/mgmj.mgmj_239_23fnacgene expertthyroid swellingtuberculosis |
| spellingShingle | Manisha Kamlesh Galani Kamlesh Jamnadas Galani Swati Nileshkumar Lakhani Tuberculosis of the thyroid gland: A rare case report MGM Journal of Medical Sciences fnac gene expert thyroid swelling tuberculosis |
| title | Tuberculosis of the thyroid gland: A rare case report |
| title_full | Tuberculosis of the thyroid gland: A rare case report |
| title_fullStr | Tuberculosis of the thyroid gland: A rare case report |
| title_full_unstemmed | Tuberculosis of the thyroid gland: A rare case report |
| title_short | Tuberculosis of the thyroid gland: A rare case report |
| title_sort | tuberculosis of the thyroid gland a rare case report |
| topic | fnac gene expert thyroid swelling tuberculosis |
| url | https://doi.org/10.4103/mgmj.mgmj_239_23 |
| work_keys_str_mv | AT manishakamleshgalani tuberculosisofthethyroidglandararecasereport AT kamleshjamnadasgalani tuberculosisofthethyroidglandararecasereport AT swatinileshkumarlakhani tuberculosisofthethyroidglandararecasereport |