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Lee, Moon, Kim, and Lee: A Case of Thyroid Amyloidosis Misrecognized as Subacute Thyroiditis
Case Report
Endocrinology and Metabolism

Endocrinology and Metabolism 2010; 25(4): 360-364.

Published online: 31 December 2010

DOI: https://doi.org/10.3803/EnM.2010.25.4.360

A Case of Thyroid Amyloidosis Misrecognized as Subacute Thyroiditis

Young Sil Lee, Seong Su Moon, Soon Kim1, Jong Im Lee2

Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Korea.

1Department of Diagnostic Radiology, Dongguk University College of Medicine, Gyeongju, Korea.

2Department of Pathology, Dongguk University College of Medicine, Gyeongju, Korea.

Corresponding author: Young Sil Lee. Department of Internal Medicine, Dongguk University College of Medicine, Seokjang-dong, Gyeongju 780-350, Korea. Tel: +82-54-770-8214, Fax: +82-54-770-8378, ysbae28@medimail.co.kr

Received 28 April 2010       Accepted 30 May 2010

Copyright © 2010 Korean Endocrine Society

Abstract

Amyloid deposition in the thyroid is found in about 30-80% of the patients with primary or secondary amyloidosis. In a few patients with amyloidosis, the thyroid is enlarged and so called amyloid goiter occurs. The thyroid function usually remains normal, but occasionally hypothyroidism or thyrotoxicosis occurs in patients with thyroid amyloidosis. We have experienced one case of thyroid amyloidosis due to bronchiectasis and the patient developed painful goiter and transient thyrotoxicosis resembling subacute thyroiditis. Biopsies from the gastric antrum, duodenum, colon, kidney and thyroid were positive for deposition of amyloid. When patients have signs and symptoms of subacute thyroiditis, but they develop an unusual course, then the diagnosis of thyroid amyloidosis should be considered.

Keywords: Amyloidosis, Thyroiditis, Subacute

Figures and Tables

Fig. 1
Transverse sonogram shows marked enlargement of both thyroid gland with high echogenicity and fine homogenous echotexture similar ground glass appearance.
enm-25-360-g001
Fig. 2
Thyroid scan with 99mTc O4 shows diffuse decreased uptake in an enlarged thyroid gland compared to salivary gland.
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Fig. 3
Fine needle biopsy shows markedly atrophic thyroid follicles and eosinophilic, amorphous material in the interstitium (H&E stain, × 200).
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Fig. 4
Congo-red stained sections of the thyroid impart. (A) A red color to deposits under usual light. (B) Apple-green birefringence under polarized light (Congo-red stain, × 200).
enm-25-360-g004

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