A 28-year-old woman develops fever, anterior neck pain radiating to the jaw, and palpitations two weeks after a viral upper respiratory infection. The thyroid is exquisitely tender. T4 is elevated with suppressed TSH and low radioiodine uptake. Histology would show:
- A Marked fibrosis extending beyond the capsule into strap muscles
- B Dense lymphocytic infiltrate with germinal centres and Hürthle cells
- C Non-caseating granulomas surrounding colloid with multinucleate giant cells ✓
- D Follicles with scalloped colloid and tall columnar epithelium
Correct answer: C. Non-caseating granulomas surrounding colloid with multinucleate giant cells
Explanation
Subacute (de Quervain, granulomatous) thyroiditis follows a viral illness, presents with tender goitre and transient thyrotoxicosis with low radioiodine uptake because damaged follicles release preformed hormone. Histology shows non-caseating granulomas with multinucleate giant cells engulfing colloid. Lymphocytic infiltrates indicate Hashimoto, dense fibrosis indicates Riedel thyroiditis, and scalloped colloid with tall cells is Graves disease.
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.