Intrathyroid hemorrhage and acute upper airway obstruction after fine needle aspiration of the thyroid gland.
OBJECTIVE
Although hematoma formation after fine needle aspiration (FNA) is the most commonly encountered complication, massive intrathyroid hemorrhage producing acute upper airway obstruction rarely occurs.


METHODS
Case report.


METHODS
This case presented a 55-year-old woman with acute intrathyroid hemorrhage producing upper airway obstruction after diagnostic FNA of multiple thyroid nodules.


RESULTS
The patient underwent endotracheal intubation and subsequent total thyroidectomy because of rapid progression of airway symptoms. During operation, the thyroid gland showed a huge, edematous, firm swelling and intrathyroidal hemorrhage with no obvious actively bleeding vessels. Microscopic examination of the resected gland revealed bilateral multiple nodular hyperplasia and massive parenchymal hemorrhage with thin-walled, aberrantly enlarged vessels.


CONCLUSIONS
Acute intrathyroid hemorrhage causing upper airway obstruction can develop after FNA of the thyroid. Prompt and adequate interventions are needed for patients with rapid progression of acute thyroid hemorrhage.
Department of Otolaryngology-Head and Neck Surgery, Cancer Research Institute, College of Medicine, Chungnam National University, Daejeon, South Korea. rohj@cnu.ac.kr
Jong-Lyel
JL
Roh
D000208:Acute Disease; D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D044963:Biopsy, Fine-Needle / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D018570:Risk Assessment; D013959:Thyroid Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D016606:Thyroid Nodule / Q000473:pathology*; D013965:Thyroidectomy / Q000379:methods; D014057:Tomography, X-Ray Computed