Journal List > J Korean Soc Endocrinol > v.20(4) > 1063804

Chin, Kwon, Kim, Koh, Park, Chon, Oh, Woo, Kim, Kim, Kim, and Yang: A Case of Thyroid Abscess Associated with Lymphocytic Thyroidits

Abstract

Acute suppurative thyroiditis is an uncommon disease, which usually affects patients with pre-existing thyroid gland pathology. Here, a case of thyroid abscess associated with lymphocytic thyroiditis, was experienced in a 35-year-old female. She had a fever, chill, sore throat and tenderness in the area of the left thyroid of 10 days duration. She visited our hospital due to her persistent sore throat, which did not subside after antibiotics treatment for 5 days. On neck ultrasonography, a heterogeneous nodule (1.3×1.5×2.1 cm) in the right lobe and cyst-like nodule (1.8×1.5×2.8 cm) in the left lobe of the thyroid were found. The thyroid gland showed slightly increased, uneven uptake of Tc-99m on a thyroid scan. Pus-like fluid aspirated from the left nodule showed numerous neutrophils and necrotic materials on cytological examination. Abundant lymphocytes were found in aspirates from the right thyroid nodule. Neither a finding suggestive of pyriform sinus nor other anomaly was discovered in the neck CT scan and UGI series. After further antibiotic treatments for 2 weeks, the inflammatory symptoms and thyroid tenderness completely subsided. However, the nodule in the right lobe of the thyroid was still palpable, but without tenderness when examined after 4 weeks.

Figures and Tables

Fig. 1
Thyroid scintigraphy shows enlarged both lobes with slightly uneven uptake pattern.
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Fig. 2
Thyroid ultrasonography shows a heterogenous, hypoechoic mass (arrow) with central anechoic area in the right lobe of the thyroid gland (A) and a cyst (arrow) with posterior acoustic enhancement in the left lobe of the thyroid gland (B).
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Fig. 3
Fine needle aspiration cytology. Smears of the right thyroid aspirate shows some epithelial cell clusters and relatively abundant lymphocytes (A). Smear of the left thyroid aspirate shows numerous neutrophils and some necrotic materials (B). (Papanicolaou stain, A: 400, B: 400).
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Fig. 4
Neck CT scan shows a nonenhanced nodule (arrow) in the right lobe of the thyroid gland.
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Fig. 5
Upper gastrointestinal series reveals no abnormal findings.
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