“HASHIMOTO THYROIDITIS”

The typical patient is a 40-year-old woman with gradual enlargement of the thyroid. Patients are usually euthyroid; however, 20% present with hypothyroidism. There is an increased risk of malignancy, mostly non-Hodgkin lymphoma. Rapid enlargement of the gland suggests malignancy. There is a low threshold for nodule biopsy (e.g. focal bulge, adenopathy, etc.).
US

 Diffusely hypoechoic gland, avascular when acute
•  Chronic phase causes an enlarged hypoechoic/heterogeneous gland, fibrous septae separating hypoechoic areas
•  Hyperaemic in chronic phase due to effect of increased thyroid stimulating hormone (TSH)

NUCLEAR MEDICINE

•  Generalised reduced uptake of technetium-99m



 

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