Pachipala Madhu Sowmitha, Aiyappan Senthil Kumar
Department of Radiodiagnosis, SRM Medical College Hospital and Research Centre, Sri Ramaswamy Memorial Institute of Science and Technology (SRMIST), Chengalpattu, IND.
Cureus. 2024 Sep 5;16(9):e68733. doi: 10.7759/cureus.68733. eCollection 2024 Sep.
Tuberculosis involving the thyroid gland is an exceptionally rare condition with varied clinical presentations, often leading to diagnostic challenges. We report two cases: a 9-year-old male with necrotic tuberculous cervical lymphadenopathy secondarily involving the thyroid gland, and a 40-year-old male with disseminated tuberculosis affecting multiple organ systems, including the thyroid gland. Both cases presented with swelling over the neck region and were evaluated using ultrasonography and contrast-enhanced computed tomography (CECT), which revealed characteristic imaging findings of thyroid involvement. Fine-needle aspiration cytology (FNAC) and TB-PCR (polymerase chain reaction for Mycobacterium tuberculosis) of the aspirate confirmed the diagnosis of tuberculosis. Early identification and medical management with anti-tubercular therapy led to successful treatment, thereby avoiding unnecessary surgical interventions. These cases signify the importance of considering thyroid tuberculosis in the differential diagnosis of thyroid lesions, especially in endemic regions, and highlight the role of imaging and FNAC in establishing a prompt diagnosis.
累及甲状腺的结核病是一种极为罕见的疾病，临床表现多样，常常给诊断带来挑战。我们报告两例病例：一例是一名9岁男性，患有坏死性结核性颈部淋巴结病，继而累及甲状腺；另一例是一名40岁男性，患有播散性结核病，累及包括甲状腺在内的多个器官系统。两例病例均表现为颈部肿胀，通过超声检查和增强计算机断层扫描（CECT）进行评估，结果显示了甲状腺受累的特征性影像学表现。细针穿刺抽吸细胞学检查（FNAC）及抽吸物的结核聚合酶链反应（TB-PCR，用于检测结核分枝杆菌的聚合酶链反应）确诊为结核病。早期识别并采用抗结核治疗进行医学管理，从而成功治愈，避免了不必要的手术干预。这些病例表明，在甲状腺病变的鉴别诊断中，尤其是在结核病流行地区，考虑甲状腺结核的重要性，并突出了影像学检查和FNAC在迅速确诊方面的作用。
