Tuberculosis of the Thyroid—a Diagnostic Enigma

Thyroid tuberculosis is very uncommon even in countries where tuberculosis is endemic. It is commonly seen secondary to tubercular infection of other organ or tissue by hematogenous spread. There are many different presentations of thyroid tuberculosis. Before the advent of fine needle aspiration cytology (FNAC), all patients had surgery and thyroid tuberculosis was diagnosed only on biopsy of specimen. Nowadays, FNAC can confirm the diagnosis in many cases, and the patient can be cured by standard anti-tubercular treatment without the need for surgery. Surgery is required only when there is suspicion of malignancy and FNAC is inconclusive.