Bir Thyroiditis Lymphomatosa (Hashimoto Hastalığı) Vak’ası

Abstract

This case study presents one of Türkiye’s earliest documented instances of Hashimoto’s thyroiditis (Struma lymphomatosa)—a rare, autoimmune, chronic inflammation of the thyroid. The 38-year-old female patient exhibited neck swelling, dysphagia, nighttime symptoms, irritability, and hand tremors. Physical exam revealed bilateral thyroid masses pressing on the trachea. A subtotal bilateral thyroidectomy was performed. Histopathological analysis confirmed: Dense lymphocytic infiltration Degenerative changes in follicular epithelium Fibrotic replacement of normal architecture Occasional multinucleated giant cells These findings substantiated the diagnosis of Hashimoto’s disease, distinct from thyroid carcinoma despite similar clinical firmness and mass effect. The authors delve into the historical origin (Hashimoto, 1912), pathogenesis theories (autoimmune, excess TSH-stimulated macrophage activity, progressive colloid digestion), and epidemiology (predominantly in women aged 40–50). The paper also highlights misdiagnosis risks, especially confusing Hashimoto’s with thyroid cancer or Riedel’s thyroiditis. Treatment options—surgery, radiation therapy, or radium therapy—are discussed, with surgery offering both therapeutic and diagnostic benefits. The role of postoperative thyroid hormone replacement and emerging interest in cortisone therapy for lymphocytic regression are noted.

Keywords

• Hashimoto thyroiditis
• Struma lymphomatosa
• Autoimmune thyroid disease
• Lymphocytic infiltration
• Subtotal thyroidectomy
• Differential diagnosis
• Cortisone therapy

A Case of Thyroiditis Lymphomatosa (Hashimoto’s Disease

Abstract

Bu çalışma, Türkiye’de nadiren belgelenmiş bir Hashimoto tiroiditi (Struma lenfomatoza) vakasını sunmaktadır. 38 yaşındaki kadın hastada boyun şişliği, yutma güçlüğü, geceleri belirginleşen semptomlar, sinirlilik ve ellerde titreme görülmüştür. Trakeayı kuşatan bilateral tiroid kitleleri tespit edilmiştir. Lokal anestezi ile subtotal bilateral tiroidektomi yapılmıştır.

References

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