Hashimoto thyroiditis

Case contributed by Jorge Ariel Montero Torres
Diagnosis almost certain

Presentation

A slowly growing mass in the neck.

Patient Data

Age: 30 years
Gender: Female
ultrasound
  • thyroid gland enlargement with a heterogeneous texture and lobulated contour on ultrasound

  • multiple hypoechoic micronodules scattered throughout, separated by echogenic septa

  • hypoechoic nodule in the posterior pole of the right thyroid lobe, potentially exhibiting both benign and malignant characteristics

  • increased Doppler signal, indicating increased vascularity in the area

Case Discussion

The case turned out to be Hashimoto thyroiditis, and the ultrasonographic characteristics of the lesions vary with the disease's state. In our case, the patient presented in an acute diffuse state, characterized by gland enlargement with lobulated margins and scattered hypoechoic nodules diffusely throughout the gland, along with increased Doppler signal 1.

Nodules in the presence of Hashimoto's thyroiditis typically appear as solitary, solid, non-calcified, and hyperechoic with a halo, while those without this condition may display cystic changes and eggshell calcifications 2.

It can be challenging to distinguish it from other diffuse thyroid parenchymal diseases such as Graves diseaseDe Quervain thyroiditis, or malignancies like thyroid lymphoma 2. Therefore, laboratory tests and clinical context always play a crucial role in the diagnosis.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.