[A thyroid pathology: The great simulator]

Area of Science:

• Endocrinology
• Infectious Diseases
• Pathology

Background:

• Tuberculosis (TB) is a significant global health issue, particularly in developing nations.
• Primary thyroid tuberculosis is an exceptionally rare manifestation of TB, frequently leading to diagnostic challenges and misdiagnosis.
• Pathological anatomy is vital for definitive diagnosis of thyroid tuberculosis.

Observation:

• A 22-year-old male presented with a two-month history of an isolated anterior cervical swelling.
• Ultrasound identified a EU-TIRADS 3 thyroid nodule; fine needle aspiration revealed a necrotizing granulomatous lesion.
• Histopathological examination of the resected thyroid tissue confirmed the presence of tubercular granulomas.

Findings:

• Fine needle aspiration cytology is instrumental in orienting the diagnosis of thyroid tuberculosis.
• Histopathology provides definitive confirmation of primary thyroid tuberculosis.
• Prompt initiation of anti-tuberculosis treatment led to a favorable clinical outcome and recovery.

Implications:

• The diagnosis of thyroid tuberculosis should be considered in patients presenting with thyroid masses, especially those from tuberculosis-endemic regions.
• Early and accurate diagnosis, aided by cytology and pathology, is essential to prevent misdiagnosis and ensure appropriate treatment.
• This case underscores the importance of considering rare presentations of common infectious diseases in clinical practice.