title: Thyroid tuberculosis in southeastern Turkey: is this the resurgence of a stubborn disease?
abstract: BACKGROUND
  While tuberculosis (TB) has been found in many parts of the body, involvement of the thyroid gland is rare. In this study we describe the clinicopathological characteristics of seven patients with primary thyroid tuberculosis (TTB).
  
  
  METHODS
  This report is a retrospective case study of seven patients with thyroid tuberculosis who were treated surgically in our clinic between 2004 and 2010. Data collected from the cases included age, sex, clinical presentation, concurrent medical illness, initial diagnosis, and history of pulmonary tuberculosis. Testing used to establish the diagnosis of TTB included thyroid function tests, histopathological examination, a tuberculin skin test, and FNAC (fine needle aspiration cytology). Surgical procedures, antitubercular therapy, and follow-up data were also analyzed.
  
  
  RESULTS
  All seven cases were females between the age of 30 and 60 years (mean = 44.1 ± 9.5 years). Four cases had neck swelling and three had additional complaints of dysphagia and dyspnea. While total thyroidectomy was performed in six patients with multinodular goiter, a lobectomy was performed in one patient in whom a solitary thyroid nodule was detected. Histopathologic changes consistent with thyroid tuberculosis were detected in all patients. Thoracic X-ray, erythrocyte sedimentation rate (ESR) test, and tuberculin skin test (PPD) were performed and all patients were screened for other possible foci of infection. In conclusion, all seven cases were diagnosed with primary tuberculosis. While the lobectomy patient was administered a 6-month antitubercular treatment, the total-thyroidectomy patients did not receive any medical treatment postoperatively. During the postoperative follow-up period, which lasted between 6 and 53 months (mean = 37.3 ± 18.6 months), none of the patients had a recurrence of disease.
  
  
  CONCLUSIONS
  Tuberculosis should be considered in the list of differential diagnoses for thyroid abscesses and nodular lesions in people living in geographic regions with a high tuberculosis prevalence.
authors.affiliation: Department of Surgery, Diyarbakir Education and Research Hospital, Op. Dr. Seref Inaloz Caddesi, 21400 Diyarbakir, Turkey. akbulutsami@gmail.com
authors.forename: Sami
authors.initials: S
authors.lastname: Akbulut
authors.forename: Nilgun
authors.initials: N
authors.lastname: Sogutcu
authors.forename: Zulfu
authors.initials: Z
authors.lastname: Arikanoglu
authors.forename: Sule
authors.initials: S
authors.lastname: Bakir
authors.forename: Abdullah
authors.initials: A
authors.lastname: Ulku
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yagmur
mesh_terms: D000328:Adult; D044963:Biopsy, Fine-Needle; D003430:Cross-Sectional Studies; D003906:Developing Countries; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006044:Goiter, Nodular / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D013959:Thyroid Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D013961:Thyroid Gland / Q000473:pathology; D013965:Thyroidectomy; D014057:Tomography, X-Ray Computed; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D014421:Turkey