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A hard thyroid mass due to plasma cell granuloma
J S Li Voon Chong1, C T Burrows, D Cave-Bigley
1Department of Endocrinology, Liverpool, UK.
International Journal of Clinical Practice
|July 17, 2001
Summary
Plasma cell granuloma of the thyroid is rare. This case highlights rapid thyroid mass development and the importance of biopsy for diagnosis and management.
Area of Science:
- Endocrinology
- Pathology
- Surgical Oncology
Background:
- Plasma cell granuloma (PCG) is an uncommon benign inflammatory condition.
- Thyroid involvement by PCG is exceptionally rare, posing diagnostic challenges.
Observation:
- A 29-year-old male with type 1 diabetes presented with acute symptoms including fever, sore throat, neck tenderness, and dysphagia.
- A rapidly enlarging, hard 8 cm thyroid mass developed over two weeks despite antibiotic treatment.
- Fine needle aspiration was inconclusive, necessitating surgical exploration.
Findings:
- Surgical exploration revealed an inflammatory process involving the thyroid, sternothyroid muscle, and parapharyngeal spaces.
- Histological examination of biopsies confirmed plasma cell granuloma.
- Immunoperoxidase staining showed a predominance of IgG, indicating an immune-mediated process.
Implications:
- Rapidly developing hard thyroid masses should raise suspicion for plasma cell granuloma.
- Histological confirmation via open biopsy or surgical removal is crucial for diagnosis.
- Complete resolution of the mass within weeks is possible following diagnosis and management.