IS case 498: Hashimoto's thyroiditis

Benita Tamrazi, MD

University of Rochester

Imaging Sciences URMC 2010
Publication Date: 2010-08-30

History

Patient is a 59-year-old female with history of hypothyroidism seen for follow-up.

Findings

Heterogeneous appearing thyroid parenchyma with markedly increased, diffuse vascularity.

Diagnosis

Hashimoto's thyroiditis

Discussion

Thyroiditis is a condition which encompasses inflammatory disorders of the thyroid gland. Chronic lymphocytic thyroiditis, also known Hashimoto’s thyroiditis, is an autoimmune disorder in which the thyroid gland is gradually destroyed. Patients present with hypothyroidism, goiter or both. The diagnosis is confirmed with laboratory testing including measurements of serum thyroid autoantibodies and thyroglobulin. Imaging of the disease process varies according to the stage. Acute Hashimoto’s thyroiditis on ultrasound appears as diffuse, hypoechoic, heterogeneous micronodular echo pattern of the entire gland with avascularity on Doppler. In the chronic stage, there are increased fibrous septa and the gland appears more lobulated with increased vascularity on Doppler. Patients are treated symptomatically with thyroid hormone replacement therapy in the hypothyroid phase of the disease.

References

1. Slatosky J, Shipton B, Wahba H. Thyroiditis: differential diagnosis and management. Am Fam Physician. 2000 Feb 15;61(4):1047-52, 1054. PMID: 10706157