AMİLOİD GUATR: OLGU SUNUMU

Amiloidoz vücuttaki birçok organ ve dokuda amorf, proteinöz materyal birikimi ile karakterize etyolojisibilinmeyen bir hastalıktır. Amiloid guatr tiroid dokusunun yoğun amiloid birikimi sonucu ortaya çıkan oldukçanadir gözlenen bir durumdur. Amiloid guatr primer ve sekonder sistemik amiloidozla birliktelik göstermekte,daha sıklıkla sekonder sistemik amiloidozla birlikte görülmektedir. Bu durum diğer guatr tiplerinden ve maligndurumlardan ayırt edilmelidir. Amiloidoz varlığı bilinen olgularda bile klinik olarak tanı nadiren öngörülebilir.Kitle etkisine bağlı semptomların giderilmesinde ve tanı konulmasında cerrahi müdahale gereklidir. Burada hızlıbüyüyen guatrı bulunan 21 yaşında bir kadın hasta sunuyoruz. Olgunun tiroidektomi materyalinin histolojikincelemesinde amiloid guatr için tanısal olan ekstrasellüler amiloid birikimi saptanmıştır
Anahtar Kelimeler:

Amiloid guatr, tiroid, amiloidoz

Amyloid Goitre: A Case Report

Amyloidosis is a disease of unknown etiology characterized by the accumulation of an amorphous, proteinaceous material in various organs and tissues of the body.Amyloid goitre is an exceedingly rare pathology due to massive amyloid infiltration of thyroid tissue. Amyloid goitre occurs in association with both primary and secondary systemic amyloidosis, more commonly in the latter. This condition has to be distinguished from other types of goitre and malignancy. The diagnosis is rarely suggested clinically even in the presence of known amyloidosis. Surgical intervention is necessary to relieve the symptoms of neck mass and establish a diagnosis.We present the case of a 21year old female patient who presented with a rapidly enlarging goitre. Histologic examination of the thyroidectomy specimen showed extracellular deposits of amyloid diagnostic of amyloid goitre.

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  • 1. Kisilevcky R. Amyloid and amyloidosis: differences, common themes, and practical considerations. Mod Pathol 1991; 4: 514-8.
  • 2. Sinha RN, Plehn JF, KinlawWB.Amyloid goiter due to primary systemic amyloidosis: A diagnostic challenge. Thyroid 1998; 8: 1051-4.
  • 3. Kapadia HC, Desai RI, Desai IM, Parikh NR. Amyloid goiter a case report. Indian J Pathol Microbiol 2001; 44:147-8.
  • 4. Kimura H, Yamashita S, Ashizawa K, Yokoyama N, Nagataki S. Thyroid dysfunction in patients with amyloid goiter. Clin Endocrinol 1997; 46: 769-74.
  • 5. Hamed G, Heffes CS, Shmookler BM, Wenig BM. Amyloid goiter: a clinicopathological study of 14 cases and review of the literature. Am J Clin Pathol 1995; 104: 306-12.
  • 6. Siddiqui MA, Gertz M, Dean D. Amyloid goiter as a manifestation of primary systemic amyloidosis. Thyroid 2007;17: 77-80.
  • 7. Villamil CF, Massimi G, D'Avella J, Cole SR. Amyloid goiter with parathyroid involvement. Arch Pathol Lab Med 2000; 124: 281-3.
  • 8. Himmetoglu C, Yamak S, Tezel GG. Diffuse fatty infiltration in amyloid goiter. Pathol Int 2007; 57: 449- 53.
  • 9. Goldsmith JD, Lai ML, Daniele GM, Tomaszewski JE, Livolsi VA. Amyloid goiter: report of two cases and review of the literature. Endocrine Pract 2000; 6: 318- 23.
  • 10. Nijhawan VS, Marwaha RK, Sahoo M, Ravishankar L. Fine needle aspiration cytology of amyloid goiter: a report of four cases.Acta Cytol 1997; 41: 830-4.
  • 11. Ozdemir BH, Uyar P, Ozdemir FN. Diagnosing amyloid goiter with thyroid aspiration biopsy. Cytopathology 2006; 17: 262-6.
  • 12. Jacob S, RamdasA, Kapoor R, Basil I. Amyloid goiter: a case report. Indian J Pathol Microbiol 2003; 46: 88-9
  • 13. Altiparmak MR, Pamuk ON, Pamuk GE, Apaydin S, Ataman R, Serdengeçti K. Amyloid goiter in familial Mediterranean fever: report on three patients and review of the literature. Clin Rheumatol 2002; 21: 497-