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. 2022 Mar:92:106876.
doi: 10.1016/j.ijscr.2022.106876. Epub 2022 Feb 25.

Rare cause of thyroid enlargement: Localized AA amyloid goiter - A case report

Tejas Chincholi  1 , Talha Ahmed  2 , Yogesh Kumar  1 , Amanda Christina Pinto  3 , Esha Mallik  1 , George M Varghese  4
Affiliations

Rare cause of thyroid enlargement: Localized AA amyloid goiter - A case report

Tejas Chincholi et al. Int J Surg Case Rep. 2022 Mar.

Abstract

Introduction: Amyloidosis is extracellular deposition of fibrillary amyloid proteins in various organs. Amyloid infiltration in thyroid is common; however, the occurrence of clinically enlarged thyroid, subsequently leading to goiter, is a rare phenomenon.

Case presentation: 36 years old female presented to our OPD with multinodular goiter. She subsequently underwent total thyroidectomy. Thyroidectomy specimen revealed amyloid deposition with characteristic congophilia and birefringence. Further evaluation revealed it to be AA amyloidosis. There were no features of systemic amyloidosis.

Discussion: Amyloidosis is classified on the type of amyloid protein. Treatment of individual types of amyloidosis is diverse, and hence identification of the protein subtype is paramount.

Conclusion: AA amyloidosis localized primarily to thyroid is infrequent, as it usually occurs with chronic inflammatory conditions or infections. Currently, there are no guidelines for the treatment of localized AA amyloid goiter. We have evidence demonstrating the successful treatment of such a condition with no recurrence noted.

Keywords: AA amyloidosis; Amyloid goiter; Amyloidosis; Case report; Thyroid enlargement.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Thyroid swelling involving both the lobes and the isthmus as seen on inspection.
Fig. 2
Fig. 2
40× hematoxylin and eosin stain showing amorphous eosinophilic material in the interfollicular and perifollicular areas suggestive of amyloid deposition.
Fig. 3
Fig. 3
200× amyloid deposition around thyroid follicles showing orange red stain with congo red on light microscopy.
Fig. 4
Fig. 4
Apple green birefringence using congo red stain highlighted by polarizing light.
Fig. 5
Fig. 5
Immunohistochemistry showing the brownish SAA deposits due to strong positivity in the amyloid deposits when stained with anti-SAA antibody.
See this image and copyright information in PMC

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