THYROIDITIS Chronic lymphocytic (autoimmune) thyro

THYROIDITIS Chronic lymphocytic (autoimmune) thyroiditis (Hashimoto’s disease)

This common condition is usually associated with raised titres of thyroid antibodies. It commonly presents as a goitre, which may be di ff use or nodular with a characteristic ‘bosselated’ feel or with established or subclinical thyroid failure. The diagno - sis often follows investigation of a discrete swelling. Features of chronic lymphocytic (focal) thyroiditis are commonly with other present on histological examination in association thyroid disease, notably toxic goitre ( Figure 55.28 ). Primary myxoedema without detectable thyroid enlargement represents the end stage of the pathological process.

Figure 55.28 Autoimmune thyroiditis (Hashimoto’s disease; struma lymphomatosa). Intense lymphocytic–plasma cell in /f_i ltration, acinar destruction and /f_i brosis.