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
References
- 1 – Cameron – Recent advances in endocrinology
- 2 – Dailey M. E., Lindsay S. H. – Relation of thyroid neoplasms to Hashimoto’s disease and thyroid gland – Arch. Surg., 1955, 70(2): 291–297
- 3 – Marshall S. F., Meissner – Struma lymphomatosa (Hashimoto's disease) – Ann. Surg., 1955, 141(5)
- 4 – Skirpan P., Reich A., Crile Jr. G. – Serum colloidal geld test: diagnosis aid for Hashimoto – Am. J. Clin. Path., 1955, 25(11): 1274–1278
- 5 – Stig Rauström – Thyroid lymphoma linked to Hashimoto’s and Brill-Symmers disease – J. Chirurgie, 1958, 76(2): 346
- 6 – Wickman W., Lamphier T. A., Pepi J., Brusch C. – Hashimoto’s Disease (Struma Lymphomatosa) – Surgery, 1957, 41: 313–321
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
- 1 – Cameron – Recent advances in endocrinology
- 2 – Dailey M. E., Lindsay S. H. – Relation of thyroid neoplasms to Hashimoto’s disease and thyroid gland – Arch. Surg., 1955, 70(2): 291–297
- 3 – Marshall S. F., Meissner – Struma lymphomatosa (Hashimoto's disease) – Ann. Surg., 1955, 141(5)
- 4 – Skirpan P., Reich A., Crile Jr. G. – Serum colloidal geld test: diagnosis aid for Hashimoto – Am. J. Clin. Path., 1955, 25(11): 1274–1278
- 5 – Stig Rauström – Thyroid lymphoma linked to Hashimoto’s and Brill-Symmers disease – J. Chirurgie, 1958, 76(2): 346
- 6 – Wickman W., Lamphier T. A., Pepi J., Brusch C. – Hashimoto’s Disease (Struma Lymphomatosa) – Surgery, 1957, 41: 313–321
Details
| Primary Language | English |
|---|---|
| Subjects | General Surgery |
| Journal Section | Case Report |
| Authors | |
| Publication Date | December 31, 1959 |
| IZ | https://izlik.org/JA64YT28ZU |
| Published in Issue | Year 1959 Volume: 12 Issue: 3-4 |