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Rare case of Rheumatoid nodules in thyroid gland parenchyma: a report
Dr Efthimios Sivridis at Department of Pathology, Democritus University of Thrace Medical School and University General Hospital of Alexandroupolis, Greece and colleagues have reported a rare case of rheumatoid nodules in thyroid gland parenchyma. The case has appeared in the Journal of Medical Case Reports.
The rheumatoid nodule is the most common extra-articular manifestation of rheumatoid arthritis. When present, it is readily identified in conventional hematoxylin and eosin sections.
A 33-year-old Greek woman was found to have hypothyroidism following a thorough investigation of migraines, after a road traffic accident. The event was complicated with craniocerebral injury necessitating tracheostomy. Her past medical history included RA of 3-year duration treated with methotrexate (2.5 mg three times per day), and topiramate medication for migraines (200 mg twice a day). On clinical examination, the thyroid gland was painless and not palpable. Laboratory tests confirmed a positive rheumatoid factor (RF) with normal antithyroglobulin (anti-TG) and thyroid peroxidase antibodies (anti-TPO) (16 U/ml and 16.7 U/ml, respectively). An ultrasound-guided fine needle aspiration biopsy performed in a private clinic showed distinct nodules in the lower pole of the left thyroid lobe, which were reported as being suggestive, though not conclusive, of malignancy (category V Bethesda) [12]. She was put on thyroxine (T4) treatment and when she became euthyroid with thyroid-stimulating hormone (TSH) of 0.89 μIU/ml, triiodothyronine (T3) of 1.30 ng/mL, and T4 of 7.2 μg/dl, she was subjected to a total thyroidectomy in our hospital.
Conclusion
To the best of our knowledge, this is the first time that rheumatoid nodules have been encountered in the thyroid gland.
For more details click on the link: https://doi.org/10.1186/s13256-019-2113-9
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