A Rare Case of Tuberculous Thyroiditis Mimicking as Follicular Neoplasm

Background: Thyroid tuberculosis is an exceptionally rare extrapulmonary manifestation of tuberculosis, even in endemic regions. It can mimic thyroid malignancy both clinically and on investigation, presenting with a painless neck swelling and constitutional symptoms like weight loss.
Methods: A 53-year-old female presented with a progressive neck swelling and significant weight loss. Evaluation included clinical examination, thyroid ultrasound, contrast-enhanced CT neck, fine needle aspiration cytology (FNAC), and biochemical tests. Due to a high suspicion of malignancy (Bethesda IV cytology and elevated thyroglobulin), the patient underwent a right hemithyroidectomy. The definitive diagnosis was made through histopathological examination of the surgical specimen and confirmed with a GeneXpert MTB/RIF test.

Keywords

Thyroid Tuberculosis; Extrapulmonary Tuberculosis; Caseating Granuloma; Hemithyroidectomy & Antitubercular Therapy

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A Rare Case of Tuberculous Thyroiditis Mimicking as Follicular Neoplasm

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