A 32-year-old woman presents with painful thyroid swelling, fever, and malaise for 2 weeks. ESR is markedly elevated at 85 mm/hr. Thyroid function shows transient thyrotoxicosis followed by hypothyroidism. Histology would most likely reveal:
- A Lymphoid follicles with germinal centers and Hurthle cell change
- B Dense fibrosis extending beyond the thyroid capsule with obliterative phlebitis
- C Noncaseating granulomas with multinucleated giant cells surrounding colloid ✓
- D Sheets of lymphocytes with Reed-Sternberg cells
Correct answer: C. Noncaseating granulomas with multinucleated giant cells surrounding colloid
Explanation
Subacute granulomatous thyroiditis (de Quervain) presents with painful thyroid, elevated ESR, and a biphasic thyroid function pattern. Histology shows granulomatous inflammation with multinucleated giant cells surrounding colloid. Option A is Hashimoto thyroiditis. Option B is Riedel thyroiditis. Option D is Hodgkin lymphoma.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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