A 35-year-old woman presents with a 3-week history of painful, tender thyroid gland, fever, and malaise. ESR is markedly elevated. A few weeks earlier she had an upper respiratory infection. On biopsy, which histological feature is most characteristic of this condition?

• A Multinucleated giant cells surrounding colloid with granuloma formation ✓
• B Dense lymphocytic infiltrate with germinal center formation
• C Extensive fibrosis infiltrating surrounding skeletal muscle
• D Papillary structures with nuclear grooves and pseudoinclusions

Explanation

Subacute granulomatous (de Quervain) thyroiditis follows a viral URI and presents with painful thyroid, elevated ESR, and systemic symptoms. Histology shows granulomatous inflammation with multinucleated giant cells surrounding colloid. Lymphocytic infiltrate with germinal centers is Hashimoto thyroiditis. Fibrosis invading muscle is Riedel thyroiditis. Papillary structures with nuclear grooves are papillary thyroid carcinoma.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.