Presentation
Loss of weight, proptosis, and diarrhea.
Patient Data
Age: 25 years
Gender: Male
From the case:
Graves disease
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Both thyroid lobes as well as the isthmus are enlarged (33 mm, 30 mm, and 8 mm in AP diameter) with coarse hypoechoic echotexture, prominent interlobular septae, and convex borders. Marked diffuse increased parenchymal vascularity of both thyroid lobes (thyroid inferno).
Laboratory results revealed:
TSH = 0.0083 mIU/L (normal 0.5 to 5.0 mIU/L) - very low
Free T4 = 5.30 ng/dL (normal 0.8 to 1.8 ng/dL) - high
Case Discussion
Ultrasound features of diffuse parenchymal disease with thyroid inferno, commonly due to Graves disease, less commonly thyroiditis. The increased vascularity in the thyroid gland is due to arteriovenous shunts.
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