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 Table of Contents  
CASE REPORT
Year : 2016  |  Volume : 13  |  Issue : 1  |  Page : 43-44

Diffuse lipomatosis of thyroid gland: A rare condition


Department of Radiology and Intervention, Bombay Hospital and Medical Research Centre, Mumbai, Maharashtra, India

Date of Web Publication5-Jan-2016

Correspondence Address:
Shaileshkumar S Garge
Room No.1502, 15th Floor, Bombay Hospital, 12, New Marine Lines, Mumbai - 400 020, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-0354.157937

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  Abstract 

Diffuse lipomatosis of the thyroid gland is a rare condition characterized by diffuse proliferation of adipose tissue in the gland. We report the case of a 51-year-old male with chronic renal failure caused by amyloidosis and past history of neck lymph node tuberculosis, 10 years before. He presented with an enlarged thyroid gland. His thyroid hormone levels were normal. Ultrasound of the neck showed an enlarged thyroid gland with diffusely increased echogenicity suggestive of fatty infiltration which was confirmed by MRI and later computed tomography (CT) scan. Patient remained euthyroid on follow-up at one year. As the natural history of this condition is unknown, further follow-up is warranted.

Keywords: Adipose tissue, euthyroid, lipomatosis, thyroid gland


How to cite this article:
Vyas PD, Garge SS, Rasool BB, Jaggi ST, Talwar IA. Diffuse lipomatosis of thyroid gland: A rare condition. Thyroid Res Pract 2016;13:43-4

How to cite this URL:
Vyas PD, Garge SS, Rasool BB, Jaggi ST, Talwar IA. Diffuse lipomatosis of thyroid gland: A rare condition. Thyroid Res Pract [serial online] 2016 [cited 2019 Jun 19];13:43-4. Available from: http://www.thetrp.net/text.asp?2016/13/1/43/157937


  introduction Top


Diffuse lipomatosis of the thyroid gland is a very rare disease, characterized by extensive infiltration of thyroid parenchyma by mature adipose tissue.[1] We present a case of thyroid lipomatosis.


  Case Report Top


A 51-year-old man presented with apainless swelling in the midline of the neck. His medical history included chronic renal failure caused by amyloidosis. On physical examination, a midline swelling in the neck which was likely to be an enlarged thyroid gland was found. It was soft, diffusely palpable and non-tender.

The free T3, free T4 and TSH levels were normal [2.9 (2.3–6.1) pg/ml, 0.86 (0.7–1.9) ng/dl, and 0.58 (0.5–6.0) uIU/ml, respectively). Test for anti-thyroglobulin antibody was negative.

Thyroid ultrasonography (USG) revealed the presence of diffuse homogenous hyperechogenecity similar to fat [Figure 1]a. Magnetic Resonance Imaging (MRI) confirmed the USG findings of diffuse homogenous fatty infiltration of the thyroid gland [Figure 1]c and [Figure 1]d. As the patient remained asymptomatic and euthyroid, he was only followed up clinically. After 1 year, a follow-up CT scan of the neck was performed which again revealed diffuse homogenous fat density in the gland [Figure 1]b.
Figure 1: (a) Thyroid USG shows diffuse homogenous hyperechogenecity in the thyroid gland (b) Axial CT scan of neck at the level of thyroid gland reveals diffuse homogenous fat density in the gland (c) Axial T1W MRI image of neck at the level of thyroid gland shows diffuse homogenous hyperintensity in the thyroid gland which on (d) Axial T1W fat-suppressed image shows complete suppression of the fat signal intensity confirming lipomatosis

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  Discussion Top


Diffuse lipomatosis of thyroid gland is characterized by diffuse proliferation of adipose tissue in the gland, sometimes associated with amyloid deposition. As the thyroid exhibits a close relationship with mesodermal structures during development, mature fat may be found around blood vessels in the subcapsular area of the anterior portion of the thyroid gland. However, the presence of mature adipose tissue between the follicles in the central portion of the thyroid gland is extremely rare.[1] This condition has been explained in different ways; the prevailing hypothesis suggests that fat remains included in the gland during the embryogenesis.[2]

Differential diagnoses likelipoma, adenolipoma and other intrathyroid fat containing masses were easily excluded, because these rare entities appear as focal nodules, well-circumscribed, within an otherwise normal gland. A benign, symmetrical lipomatosis of the upper trunk, neck, and head, known as Launois-Bensaude syndrome, should spare the thyroid gland.[3] Liposarcoma of the thyroid is a rare lesion characterised by aggressively growing tumoral tissue.[4] In our case, as other causes were excluded and features were characteristic of diffuse lipomatosis on USG and MRI, with the patient being euthyroid and asymptomatic, it was decided to follow-up without any intervention.

In conclusion, diffuse thyroid lipomatosis is an extremely rare condition characterized by diffuse fatty infiltration in thyroid stroma. Our case is an example of idiopathic diffuse lipomatosis of the thyroid gland. As the natural history of this rare condition is unknown, further follow-up is warranted.

 
  References Top

1.
Ge Y, Luna MA, Cowan DF, Truong LD, Ayala AG. Thyrolipoma and thyrolipomatosis: 5 case reports and historical review of the literature. Ann Diagn Pathol 2009;13:384-9.  Back to cited text no. 1
    
2.
Schroder S, BockerW. Lipomatous lesions of the thyroid gland: A review. Appl Pathol 1985;3:140-9.  Back to cited text no. 2
    
3.
Meningaud JP, Pitak-Arnnop P, Bertrand JC. Multiple symmetric lipomatosis: Case report and review of the literature. J Oral Maxillofac Surg 2007;65:1365-9.  Back to cited text no. 3
    
4.
Gupta R, Arora R, Sharma A, Dinda AK. Diffuse lipomatosis of the thyroid gland: A pathologic curiosity. Indian J Pathol Microbiol 2009;52:215-6.  Back to cited text no. 4
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