J Korean Surg Soc.  2012 May;82(5):317-320.

A case of Riedel's thyroiditis

• Pi GY
• Lee YS
• Hong SW
• Chang HS
• Park CS

Abstract

Riedel's thyroiditis is an extremely rare disease that is difficult to diagnose correctly using preoperative diagnostic tools because it can mimic malignant neoplasm or the fibrous variant of Hashimoto thyroiditis during preoperative physical, radiologic, and pathologic examination. We describe here a rare case of Riedel's thyroiditis in an elderly patient and its radiologic characteristics.

Keyword

Riedel's thyroiditis; Ultrasonography; X-ray computed tomography; Magnetic resonance imaging; Positron-emission tomography

MeSH Terms

Aged
Hashimoto Disease
Humans
Hydrazines
Magnetic Resonance Imaging
Positron-Emission Tomography
Rare Diseases
Thyroid Gland
Thyroiditis
Tomography, X-Ray Computed
Hydrazines

Figure

• 

  Fig. 1 Computed tomography showing mass encircling trachea and thyroid cartilage with invasion of bilateral tracheoesophageal groove and esophagus (A, B), magnetic resonance imaging demonstrating that thyroid mass was homogeneously hypo-intense on both T1- and T2-weighted images (C, D), and positron emission tomography revealing that both thyroid lobes were diffusely enlarged and showed strong fluorodeoxyglucose uptake (E, F).

• 

  Fig. 2 Microscopic findings. (A) Low power view shows diffuse and dense fibrosis with atrophic follicular cell nests and inflammatory cell infiltration (H&E, ×12.5). (B, C) The cellular nests are composed of atrophic follicular cells with lymphoplasma cells (B, H&E, ×40; C, H&E, ×100). (D) Dense and extensive collagenous fibrosis replaces entire thyroid gland and extends to parathyroid gland (H&E, ×40). (E) There are multifocal calcified areas (H&E, ×100).

Reference

1. Malotte MJ, Chonkich GD, Zuppan CW. Riedel's thyroiditis. Arch Otolaryngol Head Neck Surg. 1991. 117:214–217.

2. Hay ID. Thyroiditis: a clinical update. Mayo Clin Proc. 1985. 60:836–843.

3. Riedel BM. Diechrnische, zur Bildung eiseharter Tumoren fuhrende Entzundung de Schilddruse. Verh Dtsch Ges Chir. 1896. 24:101–105.

4. Papi G, Corrado S, Cesinaro AM, Novelli L, Smerieri A, Carapezzi C. Riedel's thyroiditis: clinical, pathological and imaging features. Int J Clin Pract. 2002. 56:65–67.

5. Bagnasco M, Passalacqua G, Pronzato C, Albano M, Torre G, Scordamaglia A. Fibrous invasive (Riedel's) thyroiditis with critical response to steroid treatment. J Endocrinol Invest. 1995. 18:305–307.

6. Wan SK, Chan JK, Tang SK. Paucicellular variant of anaplastic thyroid carcinoma. A mimic of Reidel's thyroiditis. Am J Clin Pathol. 1996. 105:388–393.

7. Papi G, LiVolsi VA. Current concepts on Riedel thyroiditis. Am J Clin Pathol. 2004. 121:Suppl. S50–S63.

8. Takahashi N, Okamoto K, Sakai K, Kawana M, Shimada-Hiratsuka M. MR findings with dynamic evaluation in Riedel's thyroiditis. Clin Imaging. 2002. 26:89–91.

9. Ozbayrak M, Kantarci F, Olgun DC, Akman C, Mihmanli I, Kadioglu P. Riedel thyroiditis associated with massive neck fibrosis. J Ultrasound Med. 2009. 28:267–271.

10. Drieskens O, Blockmans D, Van den Bruel A, Mortelmans L. Riedel's thyroiditis and retroperitoneal fibrosis in multifocal fibrosclerosis: positron emission tomographic findings. Clin Nucl Med. 2002. 27:413–415.