Hashimoto thyroiditis

Case contributed by Dr Aws Qahtan Hamdi

Presentation

A female patient presented with painless thyroid enlargement, with a status of hypothyroidism revealed by laboratory investigations associated with elevated thyroid autoantibodies.

Patient Data

Age: 40 years
Gender: Female

Thyroid images

Ultrasound

Ultrasound examination shows diffuse enlargement of both thyroid lobes with heterogeneous echotextures, associated with prominent echogenic fibrous septations and increased vascularity by color doppler study.

Case Discussion

Hashimoto thyroiditis, also known as lymphocytic thyroiditis or chronic autoimmune thyroiditis. It is one of the most common thyroid disorders. The diagnosis of Hashimoto thyroiditis is currently established by a combination of clinical features, presence of serum antibodies against thyroid antigens (mainly to thyroperoxidase and thyroglobulin), and appearance on thyroid sonogram.

Ultrasound features can be variable depending on the severity and phase of the disease. Usually, there is diffuse enlargement of the thyroid gland with a heterogeneous echotexture, associated with the presence of hypoechoic micronodules (1-6 mm) with surrounding echogenic septations. Color Doppler shows increased vascularity of both lobes of the thyroid gland. 

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