title: Histopathologic diagnosis of thyroid tuberculosis.
abstract: BACKGROUND
  Thyroid tuberculosis is rarely encountered. Due to the absence of specific signs and symptoms, the diagnosis is difficult without histopathologic examination of surgical material. In this study, we aim to present histopathologic findings of our patients with thyroid tuberculosis.
  
  
  METHODS
  We retrospectively reviewed 800 thyroidectomy specimens from the pathology laboratories of two medical centers that were obtained over a 5-year period. We reviewed clinical and laboratory data, fine-needle aspiration cytology smears, and 4-microm formalin-fixed paraffin-embedded hematoxylin-eosin sections and Erlich Ziehl Nelsen-stained sections of granulomatous thyroiditis.
  
  
  RESULTS
  We found nine cases of granulomatous thyroiditis and detected five cases of thyroid tuberculosis. Thyroid ultrasound revealed hypoechoic nodules ranging between 1.3 and 2.5 cm in all patients with thyroid tuberculosis. Fine-needle aspiration cytology smears, which showed thyrocytes, macrophages, and lymphocytes with a colloid background, were nonspecific. Microscopic examination of all thyroids revealed granulomas of different sizes, which were composed of Langhans' giant cells, epithelioid histiocytes, and lymphocytes around caseation necrosis. In Erlich Ziehl Nelsen-stained sections of three cases, bacilli were seen. Bacilli were identified in the microbiology culture of the remaining two patients.
  
  
  CONCLUSIONS
  Thyroid tuberculosis is diagnosed by histopathologic examinations and microbiologic cultures. When granulomatous thyroiditis is encountered, tuberculosis should be kept in mind and Erlich Ziehl Nelsen staining should be performed for prompt diagnosis.
authors.affiliation: Department of Pathology, Medical Faculty of Dicle University, Diyarbakir, Turkey. drselver@gmail.com
authors.forename: Selver
authors.initials: S
authors.lastname: Ozekinci
authors.forename: Bülent
authors.initials: B
authors.lastname: Mizrak
authors.forename: Gülbin
authors.initials: G
authors.lastname: Saruhan
authors.forename: Senem
authors.initials: S
authors.lastname: Senturk
mesh_terms: D000328:Adult; D044963:Biopsy, Fine-Needle; D005260:Female; D006099:Granuloma / Q000382:microbiology; D006801:Humans; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000382:microbiology / Q000473:pathology*; D013961:Thyroid Gland / Q000473:pathology; D014383:Tuberculosis, Endocrine / Q000473:pathology*