Presentation
On medical management for hypothyroidism.
Patient Data
The thyroid gland lobe maintains its butterfly shape, however both lobes are riddled with heterogeneous, patchy hypoechoic sub-centimeter foci akin to a leopard skin pattern. The right lobe measures 3.9 ml while the left lobe measures 3.0 ml in volume. Mild increase in vascularity is noted bilaterally on color Doppler imaging. Spectral Doppler evaluation of the intra-lobular vasculature shows optimal to low profile velocities bilaterally.
Case Discussion
Ultrasound features above favors Hashimoto thyroiditis. The hallmark sonographic appearance of Hashimoto thyroiditis include 'Giraffe pattern' or 'Leopard skin pattern'1. The condition is an autoimmune disorder which is also referred to as lymphocytic thyroiditis or chronic autoimmune thyroiditis2,3.