title: An Unusual Case of Hashimoto's Thyroiditis with Four Lobed Thyroid Gland.
abstract: Hashimoto's thyroiditis (HT), an autoimmune disorder, is the most prevalent cause of subclinical or overt hypothyroidism in areas with sufficient iodine intake. The gland is often diffusely enlarged, and the parenchyma is coarsened, hypoechoic, and often hypervascular on ultrasonograpy. Histopathologic appearance of HT includes lymphocyte aggregates with germinal centers, small thyroid follicles, presence of Hurthle cells, and variable fibrosis. We present a case of a 40-year-old female with suspected follicular neoplasm on fine-needle aspiration cytology of neck swelling. Intraoperatively, thyroid gland was found having four lobes separated from each other. Total thyroidectomy was done and histopathology from all four lobes revealed HT. At present, there is no literature to support the fact that such distorted thyroid anatomy may be due to the underlying disease. If we consider it as thyroid gland anomaly, no such anomaly has been mentioned in the literature till date.
authors.affiliation: Department of General and Minimal Invasive Surgery, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India.
authors.forename: Rayees Ahmad
authors.initials: RA
authors.lastname: Dar
authors.forename: Nisar Ahmad
authors.initials: NA
authors.lastname: Chowdri
authors.forename: Fazl Qadir
authors.initials: FQ
authors.lastname: Parray
authors.forename: Sabiya Hamid
authors.initials: SH
authors.lastname: Wani