Endocrinol Metab.  2010 Dec;25(4):360-364. 10.3803/EnM.2010.25.4.360.

A Case of Thyroid Amyloidosis Misrecognized as Subacute Thyroiditis

• Lee YS
• Moon SS
• Kim S
• Lee JI

• KMID: 1497763
• DOI: http://doi.org/10.3803/EnM.2010.25.4.360

Abstract

Amyloid deposition in the thyroid is found in about 30-80% of the patients with primary or secondary amyloidosis. In a few patients with amyloidosis, the thyroid is enlarged and so called amyloid goiter occurs. The thyroid function usually remains normal, but occasionally hypothyroidism or thyrotoxicosis occurs in patients with thyroid amyloidosis. We have experienced one case of thyroid amyloidosis due to bronchiectasis and the patient developed painful goiter and transient thyrotoxicosis resembling subacute thyroiditis. Biopsies from the gastric antrum, duodenum, colon, kidney and thyroid were positive for deposition of amyloid. When patients have signs and symptoms of subacute thyroiditis, but they develop an unusual course, then the diagnosis of thyroid amyloidosis should be considered.

Keyword

Amyloidosis; Thyroiditis; Subacute

MeSH Terms

Amyloid
Amyloidosis
Biopsy
Bronchiectasis
Colon
Duodenum
Goiter
Humans
Hypothyroidism
Kidney
Plaque, Amyloid
Pyloric Antrum
Thyroid Gland
Thyroiditis
Thyroiditis, Subacute
Thyrotoxicosis
Amyloid

Figure

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  Fig. 1 Transverse sonogram shows marked enlargement of both thyroid gland with high echogenicity and fine homogenous echotexture similar ground glass appearance.

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  Fig. 2 Thyroid scan with 99mTc O4 shows diffuse decreased uptake in an enlarged thyroid gland compared to salivary gland.

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  Fig. 3 Fine needle biopsy shows markedly atrophic thyroid follicles and eosinophilic, amorphous material in the interstitium (H&E stain, × 200).

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  Fig. 4 Congo-red stained sections of the thyroid impart. (A) A red color to deposits under usual light. (B) Apple-green birefringence under polarized light (Congo-red stain, × 200).

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