Primary Thyroid Tuberculosis Diagnosed with CBNAAT

Area of Science:

• Endocrinology
• Infectious Diseases
• Oncology

Background:

• Tuberculosis (TB) is endemic in India, yet primary thyroid TB is exceptionally rare.
• Clinical presentation of thyroid TB is often nonspecific, mimicking common thyroid pathologies like bacterial thyroiditis, thyrotoxicosis, thyroid carcinoma, and lymphoma.
• Traditional diagnosis relied heavily on histopathology of post-operative thyroidectomy specimens.

Purpose of the Study:

• To report a rare case of primary tuberculosis of the thyroid gland.
• To emphasize the diagnostic challenges and the importance of high clinical suspicion.
• To showcase the utility of rapid molecular diagnostic techniques in early diagnosis.

Main Methods:

• A case presentation of primary thyroid TB.
• Initial misdiagnosis as a deep neck space abscess.
• Diagnostic confirmation using cartridge-based nucleic acid amplification test (CBNAAT) on fine needle aspiration cytology (FNAC) samples.

Main Results:

• The patient, initially suspected to have a deep neck space abscess, was diagnosed with primary thyroid TB.
• CBNAAT provided a rapid and accurate diagnosis from FNAC material.
• This facilitated timely initiation of anti-TB treatment.

Conclusions:

• Primary thyroid tuberculosis is a rare differential diagnosis in patients with thyroid lesions, especially in endemic areas.
• Early suspicion and utilization of advanced molecular diagnostics like CBNAAT are crucial for timely diagnosis and management.
• FNAC with CBNAAT offers a less invasive and faster alternative to traditional histopathology for diagnosing thyroid TB.