Cases reported "Tuberculosis, Endocrine"

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1/28. Unusual presentation of tuberculosis reactivation in childhood: an anterior neck mass.

    Although extrapulmonary tuberculosis has a broad spectrum of clinical manifestations, involvement of the thyroid gland in children has been reported very rarely. The authors report a case of an 11-year-old girl with a nontender nodular swelling of the thyroid, whose symptoms, tomographic and scintigraphic features, mimicked a nodule with a cystic component. Although seldom observed, tuberculosis should be considered in the differential diagnosis of nodular lesions of the thyroid in children, especially in the patient with known history of exposure to tuberculosis.
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2/28. Tubercular involvement of the thyroid gland: a report of two cases.

    Thyroid tuberculosis is rare. In the last decade, however, the incidence of extrapulmonary forms of tuberculosis has increased. We report on 2 cases of thyroid tuberculosis. In case 1, a tubercular abscess mimicking acute thyroiditis was found which was correctly diagnosed by fine-needle aspiration biopsy (FNAb). No evidence of active disease was noticed. Pleural thickening on chest X-ray was the only sign compatible with a previous infection. In case 2, tubercular thyroiditis with lymph node enlargement was also diagnosed by FNAb in a reevaluation setting. In both cases treatment with antitubercular drugs resulted in complete recovery. Thyroid tuberculosis should be kept in mind in the differential diagnosis of thyroid nodules, notably in patients with a history of tuberculous disease. FNAb represents the main approach to making the diagnosis.
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3/28. Pituitary tuberculoma mimicking adenoma: magnetic resonance imaging.

    A case of a pituitary mass with clinical and MRI findings consistent with adenoma is presented. Transnasal transphenoidal excision biopsy showed it to be a pituitary tuberculoma. The patient was treated with antituberculous drugs, and a follow-up MRI 18 months later showed good response. MRI features and a review of published reports of the sellar tuberculoma are briefly discussed.
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keywords = pituitary
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4/28. Tuberculous granulomatous inflammation associated with adenoma of parathyroid gland manifesting as primary hyperparathyroidism.

    A 36-year-old female presented with generalized bone pain, muscular weakness and enlarged cervical lymph nodes. The biochemical findings and skeletal survey was suggestive of primary hyperparathyroidism (PHPT). CT of neck and thorax showed enlarged multiple lymph nodes in the cervical and superior mediastinal region. With a diagnosis of PHPT she underwent cervical exploration and excision of enlarged right inferior parathyroid gland along with biopsy of nodes were done. Histopathology revealed the features of right parathyroid adenoma with few foci of epithelioid granuloma and granulomatous lymphadenitis. AFB smear and culture sensitivity was negative. A positive PCR for mycobacterium tuberculosis of the homogenates of parathyroid tumor confirmed tuberculous inflammation within the parathyroid adenoma. To the best of our knowledge this is the first reported case of parathyroid adenoma associated with tuberculous pathology in a case of PHPT.
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5/28. hypercalcemia in a patient with tuberculous adrenal insufficiency.

    OBJECTIVES: To raise awareness of hypercalcemia as a rare and at times inaugural manifestation of adrenal insufficiency. CASE REPORT: Evaluation of hypercalcemia in a 43-year-old man showed adrenal insufficiency. Biopsies of the testes and adrenal glands revealed epithelioid and giant cell lesions indicating tuberculosis. Although tuberculosis can contribute to hypercalcemia, this possibility was ruled out in our patient by the low serum 1,25-dihydroxy-vitamin D3 levels and return to normal of serum calcium and renal function under hormone replacement therapy. It should be noted, however, that a course of pamidronate was given. CONCLUSION: The mechanism of hypercalcemia associated with adrenal insufficiency is controversial. hyperparathyroidism was ruled out in our patient. adrenal insufficiency should be considered in some patients with hypercalcemia.
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6/28. Sonographic findings of tuberculous thyroiditis in a patient with Behcet's syndrome.

    We report a case of tuberculous thyroiditis in a woman with Behcet's syndrome. The initial physical examination in May 1998 revealed multiple soft, nontender, mobile lymph nodes, each measuring less than 1 cm, in the left lower internal jugular chain. Sonography performed in February 2000 showed multiple small (< 1 cm), oval lymph nodes, each with an intact fatty hilum, in the left lower internal jugular chain; the thyroid gland appeared normal. Follow-up sonography 6 months later showed multifocal, heterogeneous, hypoechoic lesions with ill-defined margins in both lobes of the thyroid and several small, oval lymph nodes, each with an intact fatty hilum, in the left lower internal jugular chain. Fine-needle aspiration was performed on the largest thyroid lesion, and cytologic analysis of the aspirate revealed a small number of epithelioid histiocytes in a necrotic background, which was suggestive of tuberculosis. Follow-up sonography after 3 months of antituberculosis chemotherapy showed that the thyroid lesions had resolved.
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keywords = gland, lobe
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7/28. Tuberculosis of the thyroid: two case reports.

    Tuberculosis of the thyroid gland occurs only rarely. Since extrapulmonary tuberculosis is now seen relatively more frequently the existence of this condition should be recognized. The cases of two patients with tuberculosis involving the thyroid are presented. The first, an Asian immigrant, presented with a painless goitre with no evidence of tuberculosis elsewhere. The second was an English woman who presented with hypothyroidism due to destruction of the thyroid by tuberculosis, and who subsequently died with disseminated tuberculosis; this is the only case to report the association between myxoedema and tuberculous thyroiditis. Other manifestations of thyroid tuberculosis and the pathological types are discussed.
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8/28. Acute tuberculous abscess of the thyroid gland.

    Isolated tuberculous thyroid abscess is an extremely rare form of infection of the thyroid gland. We present a case of a female patient who presented with an acute abscess of thyroid gland associated with pain and fever and without cervical lymphadenopathy. We describe the pathology of the disease and the imaging findings with their differential diagnosis.
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9/28. Primary tuberculosis of the thyroid gland: report of three cases.

    We report on three cases with rapidly increasing thyroid masses who were referred with the provisional diagnosis of thyroid carcinoma. In the two cases, the diagnosis of tuberculosis was established after thyroidectomy, but in the third case diagnosis was made pre-operatively with acid fast bacilli (AFB) staining and culture from fine needle aspiration (FNA) material. Although rare, tuberculosis of the thyroid gland should be included in the differential diagnosis of thyroid masses. FNA, AFB staining and culture of the aspirate are important diagnostic tools in these cases.
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ranking = 5
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10/28. Acute adrenal crisis together with unilateral adrenal mass caused by isolated tuberculosis of adrenal gland.

    OBJECTIVE: To describe a patient admitted with acute adrenocortical failure and a right adrenal mass without evidence of tuberculosis, who was ultimately diagnosed with isolated adrenal tuberculosis after postoperative histopathologic evaluation. methods: A case report is presented, with clinical, laboratory, and imaging findings. We also discuss potential factors that may complicate the diagnosis of tuberculosis. RESULTS: A 61-year-old man was admitted with symptoms and signs of acute adrenal crisis. The patient had an erythrocyte sedimentation rate of 30 mm in 1 hour, a negative tuberculin skin test, a 6-cm right adrenal mass, and left adrenal nodularity in conjunction with normal findings on a computed tomographic scan of the chest. He recovered dramatically after intravenous corticosteroid treatment. Investigation, including acid-fast staining and cultures for tuberculosis of all available specimens, gastroduodenoscopy and rectosigmoidoscopy, intestinal x-ray imaging, and autoantibody studies, did not disclose the diagnosis. Subsequently, bilateral adrenalectomy revealed isolated tuberculosis of the adrenal glands on histopathologic evaluation. Quadruple antituberculous therapy was initiated, and continued follow-up of the patient is scheduled. CONCLUSION: Our case indicates that acute or chronic adrenocortical failure can occur as a result of tuberculosis of the adrenal gland, despite the absence of clinical and laboratory evidence of tuberculosis.
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