J Korean Endocr Soc.  2008 Jun;23(3):199-203. 10.3803/jkes.2008.23.3.199.

A Case of Diffuse Hemorrhage into the Thyroid Gland after Fine Needle Aspiration, and This was Treated by Arterial Embolization

• Kim EY
• Kim JM
• Kim EH
• Jeong JY
• Lee SA
• Choi JY
• Yim JH
• Lee PH
• Kim TY
• Shong YK
• Kim WB

• KMID: 1479207
• DOI: http://doi.org/10.3803/jkes.2008.23.3.199

Abstract

Although hematoma formation after fine needle aspiration cytology fine needle aspiration cytology (FNAC) is a most common complication and most of these hematomas are self-limiting with minimal pain, a massive intra-thyroidal hemorrhage that produces acute airway obstruction had rarely been reported on.

Keyword

acute hemorrhage; fine needle aspiration; thyroid gland

MeSH Terms

Airway Obstruction
Biopsy, Fine-Needle
Hematoma
Hemorrhage
Thyroid Gland

Figure

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  Fig. 1 CT of chest and neck. A. Chest CT revealed calcified nodule in left lower lobe of thyroid. B. Neck CT without contrast-enhancement revealed diffuse enlargement of thyroid gland with heterogeneous hyper-attenuated area suspicious for intra thyroidal hemorrhage. C. Neck CT with enhancement revealed diffusely enhanced thyroid gland with highly enhanced area in left lower lobe of thyroid.

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  Fig. 2 Neck lateral X-ray. Diffuse swelling was noted at the soft tissue of anterior neck.

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  Fig. 3 Angiogram of left inferior thyroid artery. No definite bleeding focus was noted. Arrow indicated left inferior thyroid artery.

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  Fig. 4 Angiogram of left external carotid artery. Left superior thyroid artery was severely congested and partial embolization was done by particle via micro catheter. Arrow indicated left superior thyroid artery.

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  Fig. 5 99m-Tc Thyroid scan. Decreased uptake of both thyroid lobes and cold nodule in left thyroid lobe lower pole was noted.

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