1/93. Thyroid function in early sub-acute thyroiditis.A 53-year-old woman with an early form of de Quervain's disease involving both thyroid lobes was found to have her thyroid uptake of iodine suppressed, although the serum thyroid hormone concentrations were normal while the administration of TRH resulted in significant increase in the serum TSH concentrations. After administration of TSH the thyroid reserve was found to below. The diagnosis of sub-acute thyroiditis was confirmed on biopsy. The above data seem to indicate that the suppression of the thyroid uptake in the early stage of de Quervain's disease may be directly caused by the inflammatory condition of the gland, rather than, as is usually the case, by the excess of thyroid hormones and, consequently, by the suppression of pituitary TSH secretion.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/93. hypoparathyroidism secondary to Riedel's thyroiditis. A case report and a review of the literature.Riedel's thyroiditis is a rare condition in which the thyroid gland is replaced by fibrous tissue. fibrosis in various distant sites is a possible concomitant event. We report a case of Riedel's thyroiditis complicated by mediastinal fibrosis, a tumefactive fibro-inflammatory lesion of the neck and primary hypothyroidism. A review of the literature in which only 8 previous cases of hypoparathyroidism secondary to Riedel's thyroiditis have been recounted concludes the report.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
3/93. Riedel's thyroiditis associated with follicular carcinoma.Riedel's thyroiditis is an uncommon disorder of unknown etiology that is characterized by an invasive fibrotic process that partially destroys the gland and extends into adjacent neck structures. Its clinical manifestation as a stony-hard, poorly defined enlargement over the thyroid gland and local compression of the trachea, esophagus and recurrent laryngeal nerve can mimic invasive thyroid carcinoma. Because Riedel's thyroiditis is a self-limiting disease, its management should be conservative. However, invasive cancer such as follicular carcinoma can occur in association with Riedel's thyroiditis. Such a concurrence completely changes the focus of management. We report a case of Riedel's thyroiditis that was found in a patient with a follicular carcinoma. The strategy of management is discussed together with a review of the relevant literature.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
4/93. Lymphocytic hypophysitis and infundibuloneurohypophysitis; clinical and pathological evaluations.This report describes the clinical and pathological characteristics of two patients with lymphocytic hypophysitis (LHy) and two with infundibuloneurohypophysitis (INHy). Two of the patients were women and two were men, and their ages were between 27 and 38 years old. This disease was not associated with either pregnancy or the postpartum period in the female patients. Two of the patients presented with diabetes insipidus, one with panhypopituitarism and right abducens paralysis and one with headache and galactorrhea. At presentation three of the patients had mild to moderate hyperprolactinemia and one had low prolactin levels. All four had abnormal magnetic resonance imaging (MRI): focal nodular enlarging of the infundibulum and normal hypophysis in one, expanding sellar masses in two, and diffusely thickened stalk with slightly enlarged pituitary gland in one. Three cases showed no sign of adenohypophysial deficiency with stimulation tests. One patient had associated chronic lymphocytic thyroiditis. Of the first three patients, one patient underwent transcranial and two underwent transnasal transsphenoidal (TNTS) surgery for mass excisions since they were thought to have pituitary tumors. Endoscopic endonasal transsphenoidal biopsy was performed in the last one with a suspicion of LHy. The pathological and immunohistochemical examinations revealed lymphocytic infiltration. hyperprolactinemia resolved with surgery in two patients and one developed diabetes insipidus as a complication. We conclude that LHy and infundibuloneurohypophysitis should be considered in the differential diagnosis of the mass lesions of the sellar region and also should be kept in the mind for the etiopathogenesis of cases of hyperprolactinemia, galactorrhea and diabetes insipidus. In suspected cases endoscopic endonasal biopsy for the histopathological diagnosis can be a safe approach.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
5/93. Occurrence of Riedel's thyroiditis in the course of sub-acute thyroiditis.Riedel's thyroiditis is an uncommon form of chronic thyroiditis characterized by an invasive fibrosclerosis of the gland, often involving surrounding tissue. The relationship of Riedel's thyroiditis to other forms of thyroiditis is not clear. We presented a 47 year-old woman first diagnosed with sub-acute thyroiditis based on clinical findings and laboratory results. Eight months later, she had a thyroidectomy operation due to an enlargement of the thyroid gland and symptoms of compression. Histopathologic evaluation showed that she had Riedel's thyroiditis, but there were some histopathologic findings of sub-acute thyroiditis as well. Until now, there has only been one case reported in which Riedel's thyroiditis was diagnosed in a patient with a history of sub-acute thyroiditis in the literature. Although aetiology of Riedel's thyroiditis is unknown, it may develop in the course of sub-acute thyroiditis.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
6/93. Extensive sterile abscess in an invasive fibrous thyroiditis (Riedel's thyroiditis) caused by an occlusive vasculitis.Riedel's thyroiditis is a rare disease determined by an invasive fibrosclerotic transformation of the thyroid gland. It may be one manifestation of multifocal fibrosis with still unknown etiology. Because it mimics carcinoma, a biopsy must be performed to get the correct diagnosis. The condition is self-limiting when confined to the neck. prognosis depends on the extent of extracervical fibrosclerosis. We present a patient with a huge cervical and mediastinal, unilateral thyroid mass expanding to the aortic curve, which led to tracheal deviation and compression with symptoms of stridor and dyspnea. These symptoms continued under a course of high-dose steroids; thus an operation was necessary to relieve the airway obstruction and limit inflammation. Intraoperative and pathological findings showed an inflammatory infiltration of the adjacent neck muscles and a sterile abscess caused by an occlusive vasculitis. Therefore, hemithyroidectomy had to be performed instead of a local limited resection.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
7/93. tamoxifen therapy in steroid resistant Reidel's thyroiditis.Riedel's thyroiditis is a rare chronic inflammatory disorder characterised by extensive fibrosis of the thyroid gland and sometimes the surrounding tissues. We report a case of Riedel's thyroiditis in a middle aged female presenting with goitre, stridor and dyspnoea. She initially responded to corticosteroid treatment and subsequently to tamoxifen. The rationale for these treatments are discussed.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
8/93. Painless thyroiditis induced by the cessation of betamethasone.We describe the first reported case of painless thyroiditis induced by an abrupt cessation of betamethasone. A 53-year-old woman experienced transient thyrotoxicosis after the abrupt cessation of celestamine, a mixture of betamethasone and chlorpheniramine. Since neither TSH receptor- nor thyroid stimulating-antibodies were negative, and thyroid scintigram did not show the thyroid gland, she was diagnosed as having painless thyroiditis. Fourteen months after the onset of thyrotoxicosis, serum TSH was detectable without hypothyroidism. We speculate that reduction in betamethasone may be one of the triggers of painless thyroiditis.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
9/93. Painless thyroiditis associated with severe inflammatory reactions in amyloid goiter: a case report.We report the case of a 64-year-old woman with rheumatoid arthritis (RA) associated with high grade fever, malaise, and painless swelling of thyroid gland. Laboratory findings showed severe systemic inflammatory reactions, including increases in various cytokines such as IL-6. gallium-67 citrate imaging revealed intense uptake in the painlessly enlarged thyroid gland. Histologically, biopsied specimens of thyroid showed diffuse amyloid infiltrations, which included amyloid A (AA) protein. Biopsies of rectum and stomach revealed similar amyloid depositions, indicating that the amyloid had a secondary origin, potentially due to RA. All clinical symptoms were relieved by intravenous pulsatile administration of methylprednisolone followed by oral prednisone, resulting in prolonged hypothyroid status. To our knowledge, this is the first case report in japan describing painless thyroiditis with severe inflammatory reactions in amyloid goiter.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
10/93. Acute suppurative thyroiditis caused by an infected piriform sinus fistula with thyrotoxicosis.We report herein an unusual case of thyrotoxicosis caused by acute suppurative thyroiditis (AST) infected through a piriform sinus fistula (PSF). A 28-year-old man presented with pain over the thyroid gland and elevated serum thyroid hormone levels, a picture similar to subacute thyroiditis. A fine-needle aspiration biopsy from the left lobe showed neutrophil infiltration, and culture from the aspirate grew anaerobic peptostreptococcus. A neck computed tomography (CT) scan showed an abscess in the thyroid gland, and barium swallow revealed the presence of PSF. Appropriate antibiotic treatment ameliorated his symptoms of infection, followed by normalization of thyroid function. Three months later, he underwent fistulectomy and partial left lobectomy. The end of the PSF track was found in the left thyroid lobe. Thus infection of the thyroid gland through the infected PSF was likely the cause of supprative thyroiditis. The unusual clinical features of AST in this patient include the presence of severe thyrotoxicosis, relatively late onset (28-years-old) of infection despite the presence of congenital PSF, and the lack of acute inflammatory signs on the overlying skin of the thyroid gland. It is important to recognize this type of AST, since fistulectomy is required to prevent recurrent AST.- - - - - - - - - - ranking = 4keywords = gland (Clic here for more details about this article) |
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