Department of General Surgery, Dr Ram Manohar Lohia Hospital and Post Graduate, Institute of Medical Education and Research, New Delhi, India.
Department of Lab Medicine, All India Institute of Medical Sciences, New Delhi, India.
Indian J Tuberc. 2021 Apr;68(2):272-278. doi: 10.1016/j.ijtb.2020.09.006. Epub 2020 Sep 12.
Thyroid tuberculosis is a rare disease. Its incidence is low even in countries where prevalence of pulmonary tuberculosis is high (0.1-0.4%). In literature, there are only a few cases which were diagnosed as thyroid tuberculosis. It can be explained by a high resistance of the thyroid gland to infectious processes. However, the prevalence of tuberculosis has increased worldwide and thyroid involvement can be a primary manifestation of the disease. The incidence of extrapulmonary tuberculosis has been showing a progressive increase in the recent years(Barnes and Weatherstone, 1979). The most frequent clinical presentation is a solitary thyroid nodule that may present as a cystic nodule. It may also present as thyroid abscess with pain, fever and other non-specific signs and symptoms. ATT results in complete cure therefore it is important to differentiate it from other form of thyroiditis. Patients are usually euthyroid, but cases of hypothyroidism and hyperthyroidism are described. For accurate diagnosis of thyroid tuberculosis, clinical and radiological features are nonspecific and histological examination is required for confirmation of diagnosis. PCR may help in diagnosis. The authors encounter 3 cases of thyroid tuberculosis in last 5 year which are described in this article. The aim of this study is to review all the cases published in literature to describe clinical presentation, appropriate diagnostic method and possible treatment options of the disease.
甲状腺结核是一种罕见的疾病，即使在肺结核发病率较高的国家（0.1-0.4%），其发病率也较低。在文献中，仅有少数病例被诊断为甲状腺结核，这可以用甲状腺对感染过程的高度抵抗力来解释。然而，全球范围内结核病的患病率有所增加，甲状腺受累可能是该疾病的主要表现形式。近年来，肺外结核的发病率呈逐渐上升趋势（Barnes 和 Weatherstone，1979）。最常见的临床表现是孤立性甲状腺结节，可能表现为囊性结节。也可能表现为甲状腺脓肿，伴有疼痛、发热和其他非特异性症状和体征。抗结核药物治疗（ATT）可导致完全治愈，因此，区分甲状腺结核与其他类型的甲状腺炎非常重要。患者通常甲状腺功能正常，但也有描述过甲状腺功能减退和甲状腺功能亢进的病例。为了准确诊断甲状腺结核，临床和影像学特征是非特异性的，需要进行组织学检查以确认诊断。PCR 可能有助于诊断。作者在过去 5 年中遇到了 3 例甲状腺结核病例，本文对此进行了描述。本研究的目的是回顾文献中发表的所有病例，描述该疾病的临床表现、适当的诊断方法和可能的治疗选择。
