Subacute granulomatous thyroiditis: histopathological spectrum, perineural inflammation, and coexisting lesions.
- 1Recep Tayyip Erdogan University, Faculty of Medicine, Department of Pathology - Rize, Türkiye.
Abstract
Objective
Subacute granulomatous thyroiditis is a self-limited inflammatory disorder and the most common cause of painful thyroid disease. Surgically treated cases offer a unique opportunity to explore its histopathological spectrum and co-occurring thyroid pathologies.Methods
We retrospectively analyzed 44 thyroidectomy specimens diagnosed with subacute granulomatous thyroiditis between 2009 and 2019, evaluating clinical data and detailed histopathological features including inflammation extent and associated thyroid lesions.Results
The cohort comprised 36 females and 8 males (mean age 48.1±8.9 years). Preoperative fine-needle aspiration cytology was performed in 68.2% but correctly suggested subacute granulomatous thyroiditis in only one case. Surgery was most indicated for multinodular goiter (63.6%). All cases exhibited confluent folliculocentric granulomas; additional findings included fibrosis (90.9%), neutrophilic infiltration (63.6%), follicular atrophy (63.6%), and perineural inflammation (63.6%). Coexisting follicular nodular disease was present in 88.6% and chronic lymphocytic thyroiditis in 15.9%. Concomitant malignancy was identified in 13 cases (29.5%), predominantly subcentimeter papillary thyroid carcinomas, with no significant clinicopathological associations (p>0.05).Conclusion
Subacute granulomatous thyroiditis demonstrates broader pathological significance than traditionally recognized. Perineural inflammation may contribute to pain generation, and the elevated malignancy rate most likely reflects incidental detection due to extensive sampling. These findings highlight diagnostic pitfalls and underscore the importance of careful pathological assessment.
Related
- Severe Doxycycline-Induced Oesophagitis With Granulomatous Inflammation Managed in a Rural Australian Hospital: A Case Report
- Hashimoto’s thyroiditis in differentiated thyroid cancer: autoimmune inflammation, immune surveillance, and tumor escape
- Cardiovascular risk factors in autoimmune thyroiditis: role of adiponectin, resistin, inflammation and auto-immunity - a cross-sectional study.
- Thymol attenuates carboplatin-induced nephrotoxicity in male rats by suppressing oxidative stress and NF-κB-mediated inflammation: A biochemical and histopathological study
- Rewiring the neural niche: Prostaglandin E₂ promotes Schwann cell-mediated perineural invasion in pancreatic cancer.
BibTeX
@article{akar2026subacute,
title = {{Subacute granulomatous thyroiditis: histopathological spectrum, perineural inflammation, and coexisting lesions.}},
author = {Muhammed Yunus Akar and Hasan Gucer},
journal = {Revista da Associacao Medica Brasileira (1992)},
year = {2026},
month = oct,
doi = {10.1590/1806-9282.20260876},
url = {https://europepmc.org/article/MED/42879591},
note = {CC BY},
}
RIS
TY - JOUR
TI - Subacute granulomatous thyroiditis: histopathological spectrum, perineural inflammation, and coexisting lesions.
AU - Muhammed Yunus Akar
AU - Hasan Gucer
PY - 2026
DA - 2026/10/12
JO - Revista da Associacao Medica Brasileira (1992)
DO - 10.1590/1806-9282.20260876
UR - https://europepmc.org/article/MED/42879591
AB - Objective Subacute granulomatous thyroiditis is a self-limited inflammatory disorder and the most common cause of painful thyroid disease. Surgically treated cases offer a unique opportunity to explore its histopathological spectrum and co-occurring thyroid pathologies.Methods We retrospectively analyzed 44 thyroidectomy specimens diagnosed with subacute granulomatous thyroiditis between 2009 and 2019, evaluating clinical data and detailed histopathological features including inflammation extent and associated thyroid lesions.Results The cohort comprised 36 females and 8 males (mean age 48.1±8.9 years). Preoperative fine-needle aspiration cytology was performed in 68.2% but correctly suggested subacute granulomatous thyroiditis in only one case. Surgery was most indicated for multinodular goiter (63.6%). All cases exhibited confluent folliculocentric granulomas; additional findings included fibrosis (90.9%), neutrophilic infiltration (63.6%), follicular atrophy (63.6%), and perineural inflammation (63.6%). Coexisting follicular nodular disease was present in 88.6% and chronic lymphocytic thyroiditis in 15.9%. Concomitant malignancy was identified in 13 cases (29.5%), predominantly subcentimeter papillary thyroid carcinomas, with no significant clinicopathological associations (p>0.05).Conclusion Subacute granulomatous thyroiditis demonstrates broader pathological significance than traditionally recognized. Perineural inflammation may contribute to pain generation, and the elevated malignancy rate most likely reflects incidental detection due to extensive sampling. These findings highlight diagnostic pitfalls and underscore the importance of careful pathological assessment.
SN - 0104-4230
SN - 1806-9282
ER -